![]() ![]() Patients who underwent surgery to treat ductal carcinoma in situ, phyllodes tumor, occult breast cancer, or local recurrence and those who initially underwent ALND, who did not undergo any axillary surgery, or who were diagnosed preoperatively with ALN metastasis or internal mammary lymph node metastasis, were also excluded. Using the criteria of the ACOSOG (American College of Surgeons Oncology Group) Z0011 trial, patients who underwent total mastectomy or neoadjuvant chemotherapy, or who exhibited tumors of clinical stage T3–4, were excluded. Patients with clinical stage T1–2 tumors who underwent breast-conserving surgery were reviewed retrospectively. Mary’s Hospital were considered eligible. Patients who underwent breast cancer surgery from January 2013 to December 2019 at Seoul St. KC21RISI0774) the need to obtain informed patient consent was waived. The study was approved by the Institutional Review Board of Seoul St. Hence, we aimed to identify preoperative status which affects SLNs positivity and patients for whom SLN frozen section biopsy can be omitted without increasing the risk of second operation for ALND. Frozen section biopsy exhibits low sensitivity in terms of micrometastasis detection and is associated with a risk of permanent tissue loss it prolongs the operation time and increases medical costs. This raises the question of whether intraoperative SLN frozen section biopsy is required. ![]() Since the publication of these studies, the ALND rate has markedly decreased worldwide. If patients’ evidence micro-metastases or only 1 or 2 metastatic SLNs, ALND can be omitted without compromising the oncological outcomes. Breast cancer patients with clinical T1–2 tumors, node-negative disease and those undergoing primary surgery are candidates for ALND omission. Frozen section biopsy is widely used to identify ALN metastases intraoperatively, reducing the need for a second operation when metastases are identified in SLNs.Ĭurrently, the need for ALND has decreased because several clinical trials have established the safety of ALND omission in early breast cancer patients with minimal axillary involvement. Axillary management, which has evolved from ALN dissection (ALND) to sentinel lymph node (SLN) biopsy is essential for axillary staging and reducing surgical morbidity without compromising oncological safety. Axillary lymph node (ALN) metastasis is one of the most important prognostic factors for early breast cancer patients. ![]()
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