Info
🌱 來自: abbr-of-breast cancer
ALND
- axillary lymph node dissection
- Available evidence suggests that axillary node dissection is associated with more harm than benefit in women undergoing breast-conserving therapy who do not have palpable, suspicious lymph nodes, who have tumors 3.0 cm or smaller, and who have 3 or fewer positive nodes on sentinel node biopsy.
for
- (1) ≥3 positive SLN; no OS benefit if <3 SLN (Z0011, JAMA 2011;305:569)
- (2) cN1-3 or positive axillary bx if surgery upfront,
- (3) clinically evident nodes or SLN+ (any) after NAC
JAMA. 2013;310(13):1385-1394. doi:10.1001/jama.2013.277804
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針對Among patients with breast cancer but no palpable lymph nodes,
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使用complete axillary node dissection provides no survival benefit
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對比compared with SLN biopsy but reduces the risk of recurrence of axillary node metastases by 1% to 3%.
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然而However, complete axillary node dissection is associated with a 14%43 risk of lymphedema compared with only 5% to 7% in patients undergoing SLN biopsy.9,47 In the future, multimodal treatment will be dependent on primary tumor features, including molecular markers, potentially rendering the staging information obtained via axillary lymph node dissection inconsequential.
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from: SLNB