Der Klinikarzt 2015; 44(2): 82-84
DOI: 10.1055/s-0035-1547506
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Lymphknotenchirurgie in der Axilla – Von der therapeutischen Intervention zur diagnostischen Beurteilung

Lymph node surgery in the axilla – From therapeutic intervention towards diagnostic evaluation
Sherko Kümmel
1   Interdisziplinäres Brustkrebszentrum, Kliniken Essen-Mitte, Essen
,
Thorsten Kühn
2   Interdisziplinäres Brustzentrum am Klinikum Esslingen
› Author Affiliations
Further Information

Publication History

Publication Date:
10 March 2015 (online)

Auch in der heutigen Zeit ist der axilläre Lymphknotenstatus beim Mammakarzinom ein entscheidender prognostischer Faktor unabhängig von der jeweiligen Tumorbiologie. Die operative Therapie der Axilla beim Mammakarzinom unterliegt in den letzten Jahren einem Wandel hin zu einer rückläufigen Radikalität.

Eve from the current point of view, the status of the axillary lymph nodes is a decisive prognostic factor in breast cancer patients irrespective of the prevailing tumor biology. In the past years surgical therapy in the axilla of breast cancer patients has undergone a paradigm shift towards reduced radicality. The importance of axillary lymph node surgery is moving more and more away from a therapeutic intervention and rather towards the necessary diagnostic assessment. The relevant data situation requires an exact analysis in order to avoid both over- and under-treatment of the patients.

 
  • Literatur

  • 1 Veronesi U, Viale G, Paganelli G et al. Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study. Ann Surg 2010; 251: 595-600
  • 2 Krag DN, Anderson SJ, Julian TB et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 2010; 11: 927-933
  • 3 Weaver DL, Ashikaga T, Krag DN et al. Effect of occult metastases on survival in node-negative breast cancer. N Engl J Med 2011; 364: 412-421
  • 4 Galimberti V, Cole BF, Zurrida S et al. International Breast Cancer Study Group Trial 23-01 investigators. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 2013; 14: 297-305
  • 5 Kühn T. Sentinel Lymph Node Biopsy in Early Breast Cancer. Breast Care (Basel) 2011; 6: 185-191
  • 6 Giuliano AE, Hunt KK, Ballman KV et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 2011; 305: 569-575
  • 7 Jagsi R, Chadha M, Moni J et al. Radiation field design in the ACOSOG Z0011 (Alliance) Trial. J Clin Oncol 2014; 32: 3600-3606
  • 8 Giuliano AE. Reply to letter: Are the standard tangential breast irradiation fields used in the ACOSOG Z0011 trial really covering the entire axilla?. Ann Surg 2013; 257
  • 9 http://www.ago-online.de/fileadmin/downloads/leitlinien/mamma/maerz2014/de/2014D_08_Operative_Therapie_des_Mammakarzinoms_unter_onkologischen_Aspekten.pdf
  • 10 Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, Lebeau A, Liedtke C, von Minckwitz G, Nekljudova V, Schmatloch S, Schrenk P, Staebler A, Untch M. Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multi-centre cohort study. Lancet Oncol 2013; 14: 609-618
  • 11 Boughey JC, Suman VJ, Mittendorf EA et al. Alliance for Clinical Trials in Oncology. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial. JAMA 2013; 310: 1455-1461
  • 12 Classe JM, Bordes V, Campion L et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy for advanced breast cancer: results of Ganglion Sentinelle et Chimiotherape Neoadjuvante, a French prospective multicentric study. J Clin Oncol 2009; 27: 726-732