Is It Possible to Reduce Even More Need for Axillary Dissection?

It has always been disappointing to receive a histology report after an axillary dissection (ALND) saying that the only positive lymph node was the sentinel lymph node (SLN). It is for this reason that there have been many efforts to create the best predictive model in order to avoid non sentinel node dissection and in fact there are in use many of them with a reasonable success rate. The publication of the multicenter study by Giuliano et al. showed a disease free survival and overall survival rate equal between patients with positive SLN with or without axillary dissection in a large group of patients. Breast surgeons around the world have long before been interested in reducing even more the need for axillary lymph node dissection, so they easily grasped the chance of those results and applied them in their practice. Objections have been expressed regarding the integrity of the study methods and the results which make the need for a second study to confirm those results absolutely necessary.