Q) 47 year old premenopausal lady with a 3X 3cm left breast lump with IDC grade III, TNBC.
On examination, there is a single subcentimetric mobile soft mobile ipsilateral axillary LN palpable. Usg nodes no loss of hilum. Management of axilla?
a) SLND
b) ALND
c) Radiotherapy only
d) No treatment
Ans a
Selective lymph node dissection
ACOSOG Z0011 trial 0 (stages I and II) in patients who undergo breast conservation therapy, axillary lymph node dissection does not improve locoregional control or survival.
This trial has demonstrated the safety of limiting axillary surgery to the SLNB without performing formal axillary dissection for sentinel node positivity.
This avoids of the morbidity of the axillary dissection.
If node is positive the patient should receive adjuvant chemotherapy and radiation therapy.
