Therapeutic strategies of axillary treatment for early breast cancer patients with positive sentinel lymph nodes

Abstract

For patients with positive sentinel lymph nodes, axillary lymph node dissection (ALND) is the conventional treatment. However, ALND can cause seroma, the upper limb dysfunction, edema and alternative complications. Z0011, IBCSG 23-01 and AMAROS phase Ⅲ randomized controlled clinical trials recommend ALND after sentinel lymph node biopsy in N0 patients, which provides a novel option for axillary lymph node treatment, but also brings new challenges to the decision of adjuvant radiotherapy. In this paper, based upon these three clinical trials and latest literatures related to the risk of axillary lymph node metastasis and recurrence, the therapeutic strategies including surgery and adjuvant radiotherapy for patients with positive sentinel lymph nodes are reviewed and summarized. Key words: Early breast neoplasm/radiotherapy; Positive sentinel lymph node; Axillary lymph node