Journal: Journal of the Egyptian National Cancer Institute
This publication reviews the evolving management of the axilla in early breast cancer patients with low-volume, biopsy-proven nodal disease.
It highlights that landmark trials support safely omitting axillary lymph node dissection (ALND) in patients with 1-2 positive nodes.
While prospective data are limited, current NCCN guidelines endorse sentinel lymph node biopsy (SLNB) for patients with 1-2 suspicious or biopsy-confirmed positive nodes undergoing primary surgery.
The review emphasizes the role of tumor biology and response to neoadjuvant chemotherapy in guiding axillary treatment decisions, reinforcing the trend toward de-escalation of axillary surgery in clinically node-positive patients.