Évaluation du creux axillaire en 2024 : point de vue du chirurgien et rôle du radiologue

Abstract

For patients with breast cancer, de-escalation of armpit surgical treatments happened during the last twenty years to reduce the morbidity mainly induced by complete axillary lymph node dissection, with a broadening of sentinel lymph node biopsy indications and, more recently, the development of targeted lymph node excision, with no impact on patient survival. Axillary ultrasound combined with clinical examination can predict the tumour burden in the axilla. At the same time, the radiologist's role has evolved, as they must describe the number of suspicious lymph nodes, which determines surgical management. Patients having fewer than two suspicious lymph nodes are eligible for sentinel lymph node biopsy. Ultrasound-guided fine-needle aspiration or core biopsy will provide proof of lymph node involvement.