조기유방암에서 겨드랑이 림프절 수술의 최근 변화

Over the past decade, axillary surgery in early breast cancer has changed significantly. There has been a paradigm shift of acknowledging the role of axillary surgery as a staging process rather than a therapeutic intervention. Axillary lymph node dissection can be avoided in selected patients with limited metastatic lymph node involvement. Sentinel lymph node biopsy can be performed in patients who have excellent axillary response after neoadjuvant chemotherapy. Omission of axillary surgery could be considered whenever axillary lymph node status would not affect adjuvant treatment plan. Efforts toward de-escalation of axillary surgery continue. Ongoing studies are investigating the role of adjuvant regional radiotherapy in women with positive nodes after neoadjuvant chemotherapy and exploring the oncologic safety of omitting axillary surgery in excellent responders. This reviews the recent advances and new approaches to local therapy of the axilla in breast cancer.