Axillary lymph node management in breast cancer with positive sentinel lymph node biopsy

Table 2 Considerations for omission of completion axillary lymph node dissection in patients with positive sentinel lymph node

Axillary lymph node dissection may be omitted

T1 or T2 primary

One or two positive SLN without extra-capsular extension

Lumpectomy and conventional radiation therapy planned

ER and PR positive, Her2/Neu negative (equivalent to Luminal A) biology

Patient older than 65 yr old

Ductal histology

Axillary lymph node dissection should be the standard but omission could be discussed in an individualized basis

Patient younger than 65 yr old

Biology other than Luminal A

Lobular histology

Axillary lymph node dissection should be performed

T3, T4 or inflammatory primary

More than two positive SLN and/or extra-capsular extension

Mastectomy or unconventional radiation therapy planned

SLN: Sentinel lymph node.