The importance of axillary lymph node metastases in breast cancer patients
Summary
Axillary node status is the most important prognostic information regarding treatment
and prognosis for breast cancer patients. Localisation and number of involved lymphnodes
add further information and are of prognostic relevance as well. The problem of the
involvement of different axilla levels as well as skip metastases are discussed. Sentinel
lymphnode dissection is still considered investigational as well as axilla downstaging
by preoperative chemotherapy. New prognostic markers are helpful in individual situations
but are not yet considered as standard procedures. Conclusions of practical relevance
are summarised.
Zusammenfassung
In dieser Übersichtsarbeit wird die Bedeutung des Befalls axillärer Lymphknoten beim
Mammakarzinom dargelegt. Die Frage der Lokalisation, der Anzahl befallener Lymphknoten,
das Problem der Skip-Metastasierung ebenso wie die „Sentinel”-Lymphknotendissektion
werden bezüglich prognostischer und therapierelevanter Information diskutiert. Downstaging
durch präoperative Chemotherapie ebenso wie der Einsatz neuer prognostischer Marker
sind noch nicht standardmäßig etabliert. Es werden allgemeine Empfehlungen für die
klinische Praxis formuliert.
Key words
Breast - cancer - axillary - lymph nodes
Schlüsselwörter
Mammakarzinom - Lymphknoten - Axilla
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Prof. Dr. T. Cerny
Fachbereich Onkologie/Hämatologie
Kantonsspital St. Gallen
CH-9007 St. Gallen
Phone: Tel.: +41-71/4 94 10 62
Fax: Fax: +41-71/4 94 28 78
Email: e-mail: thomas.cerny@kssg.ch