Affiliations: Department of Radiation Oncology, Harvard Medical School; and Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA | Maastricht University Medical Centre, Division of Medical Oncology, Department of Internal Medicine, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
Correspondence:
[*]
Correspondence to: Abram Recht, M.D., Professor, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, East Campus, Finard Building B25, 330 Brookline Ave, Boston MA 02215, USA. Tel.: +1 617 667 2345; Fax: +1 617 667 4990; E-mail: arecht@bidmc.harvard.edu
Abstract: The substitution of sentinel node biopsy for axillary dissection for patients with early-stage breast cancer has reduced the morbidity of pathologic axillary nodal staging substantially. However, this has resulted in substantial controversy about how to manage patients with positive sentinel nodes. Radiation therapy has been used for many years instead of or in addition to axillary sampling or axillary dissection. This article will examine parts of this experience relevant to the treatment of patients with positive sentinel node biopsy, the limited data on outcome of patients with a positive sentinel node biopsy who do not undergo completion dissection, and the toxicities of axillary irradiation. Finally, I suggest an overall approach to the management of patients with a positive sentinel node biopsy.
DOI: 10.3233/BD-2010-0295
Journal: Breast Disease, vol. 31, no. 2, pp. 91-97, 2010
