7,11] Several studies have evaluated the response of positive axillary nodes
to NACT (Table 1).
52 and mean number of axillary nodes
dissected was 14 (range 5--21).
5 Gy in 3 fractions in patients with high risk features for local recurrence like high grade, positive axillary nodes
, lymphovascular invasion and close or positive surgical resection margins.
In such cases, the updated guideline "recommends that these patients receive postmastectomy radiotherapy only if there is already sufficient information to justify its use without needing to know that additional axillary nodes
Evaluation of the axillary nodes
is currently part of breast cancer staging and can help the clinician determine the need for adjuvant chemotherapy.
Clinicopathologic factors predicting involvement of nonsentinel axillary nodes
in women with breast cancer.
No axillary adenopathy was identified as the high signal intensity on the silicone sensitive sequence was not appreciated prospectively to correspond to silicone within level I and II axillary nodes
Relation of number of positive axillary nodes
to the prognosis of patients with primary breast cancer.
In the node-negative patients, one recurrence was in the nipple-areolar complex at 82 months, and one was in axillary nodes
after negative sentinel lymph node biopsy at 20 months.
This may involve complete removal of both breasts including the axillary lymph nodes (total mastectomy); removal of the breasts only with the axillary nodes
intact (modified mastectomy); or removal of as much breast tissue as possible with the nipples intact (subcutaneous or nipple-sparing mastectomy).
There is little debate over whether women with clinically suspect or matted axillary nodes
and those with macrometastases present in three or more SLNs require definitive treatment of the axilla.
Until recently, clinical practice guidelines advised complete axillary node
dissection--removal of all 20-30 axillary nodes
--if a woman's sentinel node biopsy was positive.