Jusqu’où aller dans la désescalade thérapeutique en chirurgie du cancer du sein infiltrant : contre la désescalade

Abstract

CONS: Therapeutic de-escalation in breast cancer surgery is not recommanded for all patients. Concerning the axillary management, there are still some contraindications for practicing sentinel node, and avoiding axillary dissection is not safe for more than 3 positive sentinel nodes and in the absence of adjuvant treatment. Mastectomy can also be preferred by patients rather than conservative surgery, especially in case of genetic mutation, or for oncological reasons. Larger glandular resections, known as oncoplasties, should also be chosen in case of associated ductal carcinoma in situ and risky subgroups of local recurrence after neoadjuvant therapy. Finally, all patients will not benefit from ambulatory surgery.