Should Axillary Lymph Node Dissection be Done for Breast Cancer?

摘要

Selective sentinel lymphadectomy or sentinel lymph node (SLN) biopsy has been shown to be an excellent and minimally invasive staging procedure for early breast cancer with no clinical adeno-pathy. When the SLN is negative, no axillary lymph node dissection (ALND) is needed. The debate becomes active as to what should be done when the SLN is positive. Dr. Reintgen presented the pro view that complete ALND should be done whereas Dr. Cady presented the con view. The potential role of axillary lymph node dissection (ALND) in early breast cancer consists of staging the patient, regional control, and perhaps survival. It has been well established that lymph node status is the most important predictor of patients' clinical outcome. Therefore, ALND has been considered to be an excellent staging procedure (1). However, the therapeutic role of the ALND has not been well established. In the sentinel lymph node (SLN) era, selective sentinel node procedure has become standard for staging the axillary (2-4). The critical question is whether patients require complete ALND if the SLN(s) are positive.