Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer


Gastric & Breast Cancer e-journal

DOI: 10.2122/gbc.2008.0079


COMMENTARY

Benefits and harms in avoiding Axilla Lymphadenectomy in Breast Cancer
Johannes Zacherl, M.D.
 

Over the last years there has been a trend towards less extensive surgery for improving quality of life in the multimodality treatment of breast cancer. Based on randomized evidence for the safety and efficacy of breast-conserving surgery (BCS) and sentinel nodel biopsy (SNB) as well as the efficacy of empirical cytotoxic and targeted (anti-HER2, anti-ER) agents, early-stage breast cancer treated by minimal surgery has been increased [1]. However, longer than 10-years survival results have demonstrated a local recurrence risk after BCS ranging between 10 and 20%% suggestive how carefully should candidate patients be selected for BCS [2,3]. Recently, a landmark meta-analysis study has demonstrated that one of four patients who develops local recurrence die of the disease and overall survival can significantly be reduced by inadequate local control [4]. With the wider clinical use of SNB and a trend towards sparing (ALD) even by positive SNB emerge similar harms for nodal recurrence and overall survival?

Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

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last update: 3 February 2004