ABSTRACT
This chapter is about the management of axilla in breast cancer patients. The axillary nodal status is the most significant prognostic factor of breast cancer. Breast cancer is staged both clinically and postoperatively by cTNM and pTNM methods. Axilla is initially evaluated by clinical examination, and if clinically significant nodes are palpable, fine needle aspiration cytology (FNAC) from the node is conducted. Clinically impalpable axilla is then evaluated with ultrasonography, and if required, an axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB) is carried out. ALND is associated with significant morbidity such as lymphedema and arm movement restriction. SLNB is the recommended method of axillary staging in node-negative diseases, whereas ALND is the standard of care for node-positive axilla. The text also talks about SLNB with SentiMag, OSNA, and SLNB after neoadjuvant chemotherapy, axillary de-escalation surgery, and targeted axillary dissection.
