Editorial
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Dec 10, 2014; 5(5): 792-794
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.792
Towards optimal management of the axilla in the context of a positive sentinel node biopsy in early breast cancer
Umar Wazir, Aisling Manson, Kefah Mokbel
Umar Wazir, Aisling Manson, Kefah Mokbel, The London Breast Institute, Princess Grace Hospital, London W1U 5NY, United Kingdom
Author contributions: Wazir U, Manson A and Mokbel K contributed equally to this work; Wazir U and Mokbel K performed the research; Manson A performed the proof-reading; Manson A contributed the illustrations; Wazir U and Mokbel K wrote the paper.
Supported by Grants from the Breast Cancer Hope Foundation (London, United Kingdom)
Correspondence to: Kefah Mokbel, Professor, The London Breast Institute, Princess Grace Hospital, 45 Nottingham Place, London W1U 5NY, United Kingdom. kefahmokbel@hotmail.com
Telephone: +44-207-9082040 Fax: +44-207-9082275
Received: May 18, 2014
Revised: June 22, 2014
Accepted: September 6, 2014
Published online: December 10, 2014
Processing time: 207 Days and 11 Hours
Abstract

The sentinel lymph node biopsy (SLNB) was initially pioneered for staging melanoma in 1994 and it has been subsequently validated by several trials, and has become the new standard of care for patients with clinically node negative invasive breast cancer. The focussed examination of fewer lymph nodes in addition to improvements in histopathological and molecular analysis has increased the rate at which micrometastases and isolated tumour cells are identified. In this article we review the literature regarding the optimal management of the axilla when the SLNB is positive for metastatic disease based on level 1 evidence derived from randomised clinical trials.

Keywords: Sentinel lymph node biopsy; Early breast cancer; Axillary radiotherapy; Axillary dissection; Evidence-based medicine

Core tip: There has been a shift in the management of the axilla when the sentinel lymph node biopsy is positive towards less radical surgery thus reducing the incidence of arm morbidity and improving the quality of life of our patients.