Axillary management after neoadjuvant treatment

Giacomo Montagna, Giovanni Corso, Rosa Di Micco, Nathalie van Den Rul, Nicola Rocco

Research output: Contribution to journalReview articlepeer-review


Since its introduction nearly 30 years ago, sentinel lymph node biopsy (SLNB) has become the standard technique to stage the axilla for the great majority of patients with early breast cancer. While the accuracy of SLNB in clinically nodenegative patients who undergo neoadjuvant chemotherapy (NAC) is similar to the upfront surgery setting, modifications of the technique to improve the false negative rate are necessary in node-positive patients at presentation. Currently, patients who present with matted nodes, cN1 patients who fail to downstage to cN0 with NAC and those with pathological residual disease have an indication to undergo axillary lymph node dissection. Ongoing trials will confirm if extensive nodal irradiation can replace surgery in patients with residual nodal disease after NAC and if nodal radiotherapy can be omitted in patients who achieve nodal pathological complete response. The aim of this review was to focus on the open questions on the management of the axilla after NAC.

Original languageEnglish
Pages (from-to)400-407
Number of pages8
JournalMinerva Chirurgica
Issue number6
Publication statusPublished - Dec 2020


  • Adjuvant
  • Axilla
  • Breast neoplasms
  • Chemotherapy
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Surgery


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