Axillary Surgery Following Neoadjuvant Chemotherapy - Multidisciplinary Guidance From the Association of Breast Surgery, Faculty of Clinical Oncology of the Royal College of Radiologists, UK Breast Cancer Group, National Coordinating Committee for Breast Pathology and British Society of Breast Radiology
Axillary Surgery Following Neoadjuvant Chemotherapy - Multidisciplinary Guidance From the Association of Breast Surgery, Faculty of Clinical Oncology of the Royal College of Radiologists, UK Breast Cancer Group, National Coordinating Committee for Breast Pathology and British Society of Breast Radiology
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DOI：
10.1016/j.clon.2019.05.021
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发表时间：
2019-09-01
影响因子：
3.4
通讯作者：
Doughty, J.
中科院分区：
文献类型：
--
作者：
Gandhi, A.;Coles, C.;Doughty, J.
目的：这些多学科指南旨在为接受早期乳腺癌新辅助化疗的患者的腋窝手术治疗提供临床上有用的、基于证据的建议。材料和方法：在对已发表的证据进行审查后，代表乳腺癌多学科会议中所有学科的写作小组编写了指南。主要建议：对于临床上腋窝淋巴结阴性的患者，可以在化疗之前或完成时进行前哨淋巴结活检（SNB）。新辅助化疗（NACT）。对于临床上腋窝淋巴结阳性的患者，完成 NACT 后可以安全地考虑 SNB。应使用双重映射删除四个节点。如果发现先前转移灶有完全病理反应的证据，则可以进行腋窝放射治疗。如果在 SNB 内发现残留癌（孤立的肿瘤细胞、微观或宏观转移），则进行腋窝淋巴结清扫术。 (C) 2019 年皇家放射科医生学院。由爱思唯尔有限公司出版。保留所有权利。
Aims: These multidisciplinary guidelines aim to provide clinically helpful, evidence-based recommendations on the surgical management of the axilla in patients who have received neo-adjuvant chemotherapy for early breast cancer.Materials & methods: Following a review of published evidence, a writing group representing all disciplines quorate within a breast cancer multidisciplinary meeting prepared the guidelines.Key recommendations: In patients presenting with clinically node negative axillae, sentinel node biopsy (SNB) may be performed prior to or on completion of neo-adjuvant chemotherapy (NACT). In patients presenting with clinically node positive axillae, SNB may be safely considered following completion of NACT. Four nodes should be removed with dual mapping. If evidence of complete pathological response of previous metastases is seen, axillary radiotherapy may be offered. If residual cancer (isolated tumour cells, micro- or macrometastes) is seen within the SNB, offer axillary node dissection. (C) 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.