Friedrich, Michael, Kuehn, Thorsten, Janni, Wolfgang, Mueller, Volkmar, Banys-Pachulowski, Maggie, Kolberg-Liedtke, Cornelia, Jackisch, Christian, Krug, David, Albert, Ute-Susann, Bauerfeind, Ingo, Blohmer, Jens, Budach, Wilfried, Dall, Peter, Fallenberg, Eva M., Fasching, Peter A., Fehm, Tanja, Gerber, Bernd, Gluz, Oleg, Hanf, Volker, Harbeck, Nadia, Heil, Joerg, Huober, Jens, Kreipe, Hans-Heinrich, Kuemmel, Sherko ORCID: 0000-0001-9355-494X, Loibl, Sibylle, Lueftner, Diana, Lux, Michael Patrick, Maass, Nicolai, Moebus, Volker, Mundhenke, Christoph, Nitz, Ulrike, Park-Simon, Tjoung-Won, Reimer, Toralf, Rhiem, Kerstin, Rody, Achim, Schmidt, Marcus, Schneeweiss, Andreas, Schuetz, Florian, Sinn, Hans-Peter ORCID: 0000-0003-2836-6699, Solbach, Christine, Solomayer, Erich-Franz, Stickeler, Elmar, Thomssen, Christoph, Untch, Michael, Witzel, Isabell, Woeckel, Achim, Thill, Marc and Ditsch, Nina (2021). AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update. Geburtshilfe Frauenheilkd., 81 (10). S. 1112 - 1121. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-8804

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Abstract

For many decades, the standard procedure to treat breast cancer included complete dissection of the axillary lymph nodes. The aim was to determine histological node status, which was then used as the basis for adjuvant therapy, and to ensure locoregional tumour control. In addition to the debate on how to optimise the therapeutic strategies of systemic treatment and radiotherapy, the current discussion focuses on improving surgical procedures to treat breast cancer. As neoadjuvant chemotherapy is becoming increasingly important, the surgical procedures used to treat breast cancer, whether they are breast surgery or axillary dissection, are changing. Based on the currently available data, carrying out SLNE prior to neoadjuvant chemotherapy is not recommended. In contrast, surgical axillary management after neoadjuvant chemotherapy is considered the procedure of choice for axillary staging and can range from SLNE to TAD and ALND. To reduce the rate of false negatives during surgical staging of the axilla in pN+(CNB) stage before NACT and ycN0 after NACT, targeted axillary dissection (TAD), the removal of > 2 SLNs (SLNE, no untargeted axillary sampling), immunohistochemistry to detect isolated tumour cells and micro-metastases, and marking positive lymph nodes before NACT should be the standard approach. This most recent update on surgical axillary management describes the significance of isolated tumour cells and micro-metastasis after neoadjuvant chemotherapy and the clinical consequences of low volume residual disease diagnosed using SLNE and TAD and provides an overview of this year's AGO recommendations for surgical management of the axilla during primary surgery and in relation to neoadjuvant chemotherapy.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Friedrich, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuehn, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Janni, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, VolkmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Banys-Pachulowski, MaggieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kolberg-Liedtke, CorneliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jackisch, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krug, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Albert, Ute-SusannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauerfeind, IngoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blohmer, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Budach, WilfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dall, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fallenberg, Eva M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fasching, Peter A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fehm, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerber, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gluz, OlegUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hanf, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harbeck, NadiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heil, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huober, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreipe, Hans-HeinrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuemmel, SherkoUNSPECIFIEDorcid.org/0000-0001-9355-494XUNSPECIFIED
Loibl, SibylleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lueftner, DianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lux, Michael PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maass, NicolaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moebus, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mundhenke, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nitz, UlrikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Park-Simon, Tjoung-WonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reimer, ToralfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rhiem, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rody, AchimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneeweiss, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schuetz, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sinn, Hans-PeterUNSPECIFIEDorcid.org/0000-0003-2836-6699UNSPECIFIED
Solbach, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Solomayer, Erich-FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stickeler, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thomssen, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Untch, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Witzel, IsabellUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Woeckel, AchimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thill, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ditsch, NinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-607394
DOI: 10.1055/a-1499-8431
Journal or Publication Title: Geburtshilfe Frauenheilkd.
Volume: 81
Number: 10
Page Range: S. 1112 - 1121
Date: 2021
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1438-8804
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
POSITIVE BREAST-CANCER; SENTINEL NODE BIOPSY; CLIPPED NODE; LYMPH-NODES; SURGERY; MULTICENTER; DISSECTION; LOCALIZATION; DISEASE; VALIDATIONMultiple languages
Obstetrics & GynecologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60739

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