Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound

Michael Y Chen,1 William E Gillanders1,2 1Department of Surgery, Washington University, St Louis, MS, USA; 2Siteman Cancer Center in St. Louis, St Louis, MS, USACorrespondence: William E GillandersSiteman Cancer Center in St. Louis, 660 South Euclid Avenue Campus Box 8109, St Louis, MS, 63110, USATe...

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Autores principales:	Chen MY, Gillanders WE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	breast cancer axillary staging slnb alnd axillary ultrasound z0011 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/74bf8ffc35e7479f8d32e70d39753021
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spelling	oai:doaj.org-article:74bf8ffc35e7479f8d32e70d397530212021-12-02T14:43:49ZStaging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound1179-1314https://doaj.org/article/74bf8ffc35e7479f8d32e70d397530212021-05-01T00:00:00Zhttps://www.dovepress.com/staging-of-the-axilla-in-breast-cancer-and-the-evolving-role-of-axilla-peer-reviewed-fulltext-article-BCTThttps://doaj.org/toc/1179-1314Michael Y Chen,1 William E Gillanders1,2 1Department of Surgery, Washington University, St Louis, MS, USA; 2Siteman Cancer Center in St. Louis, St Louis, MS, USACorrespondence: William E GillandersSiteman Cancer Center in St. Louis, 660 South Euclid Avenue Campus Box 8109, St Louis, MS, 63110, USATel +1 314 747 0072Email gillandersw@wustl.eduAbstract: Axillary lymph nodes have long been recognized as a route for breast cancer to spread systemically. As a result, staging of the axilla has always played a central role in the treatment of breast cancer. Anatomic staging was believed to be important for two reasons: 1) it predicts prognosis and guides medical therapy, and 2) it is a potential therapy for removal of disease in the axilla. This paradigm has now been called into question. Prognostic information is driven increasingly by tumor biology, and trials such as the ACOSOG Z0011 demonstrates removal of axillary disease is not therapeutic. Staging of the axilla has undergone a dramatic de-escalation; however, sentinel lymph node biopsy (SLNB) is still an invasive surgery and represents a large economic burden on the healthcare system. In this review, we outline the changing paradigms of axillary staging in breast cancer from emphasis on anatomic staging to tumor biology, and the evolving role of axillary ultrasound, bringing patients less invasive and more personalized therapy.Keywords: breast cancer, axillary staging, SLNB, ALND, axillary ultrasound, Z0011Chen MYGillanders WEDove Medical Pressarticlebreast canceraxillary stagingslnbalndaxillary ultrasoundz0011Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 13, Pp 311-323 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	breast cancer axillary staging slnb alnd axillary ultrasound z0011 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	breast cancer axillary staging slnb alnd axillary ultrasound z0011 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Chen MY Gillanders WE Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
description	Michael Y Chen,1 William E Gillanders1,2 1Department of Surgery, Washington University, St Louis, MS, USA; 2Siteman Cancer Center in St. Louis, St Louis, MS, USACorrespondence: William E GillandersSiteman Cancer Center in St. Louis, 660 South Euclid Avenue Campus Box 8109, St Louis, MS, 63110, USATel +1 314 747 0072Email gillandersw@wustl.eduAbstract: Axillary lymph nodes have long been recognized as a route for breast cancer to spread systemically. As a result, staging of the axilla has always played a central role in the treatment of breast cancer. Anatomic staging was believed to be important for two reasons: 1) it predicts prognosis and guides medical therapy, and 2) it is a potential therapy for removal of disease in the axilla. This paradigm has now been called into question. Prognostic information is driven increasingly by tumor biology, and trials such as the ACOSOG Z0011 demonstrates removal of axillary disease is not therapeutic. Staging of the axilla has undergone a dramatic de-escalation; however, sentinel lymph node biopsy (SLNB) is still an invasive surgery and represents a large economic burden on the healthcare system. In this review, we outline the changing paradigms of axillary staging in breast cancer from emphasis on anatomic staging to tumor biology, and the evolving role of axillary ultrasound, bringing patients less invasive and more personalized therapy.Keywords: breast cancer, axillary staging, SLNB, ALND, axillary ultrasound, Z0011
format	article
author	Chen MY Gillanders WE
author_facet	Chen MY Gillanders WE
author_sort	Chen MY
title	Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
title_short	Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
title_full	Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
title_fullStr	Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
title_full_unstemmed	Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound
title_sort	staging of the axilla in breast cancer and the evolving role of axillary ultrasound
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/74bf8ffc35e7479f8d32e70d39753021
work_keys_str_mv	AT chenmy stagingoftheaxillainbreastcancerandtheevolvingroleofaxillaryultrasound AT gillanderswe stagingoftheaxillainbreastcancerandtheevolvingroleofaxillaryultrasound
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Staging of the Axilla in Breast Cancer and the Evolving Role of Axillary Ultrasound

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