# Uncertainties and controversies in axillary management of patients with breast cancer.

**Organizacion:** EUBREAST
**Autores:** Weber WP, Davide Gentilini O, Morrow M et al.
**Revista:** Cancer Treat Rev (2023)
**PMID:** 37126938 | **PMCID:** PMC10752145
**DOI:** [10.1016/j.ctrv.2023.102556](https://doi.org/10.1016/j.ctrv.2023.102556)
**Fuente:** PubMed Central (open access)

## Relevancia
Grupo colaborativo europeo enfocado especificamente en cirugia mamaria. Encuestas y consensos internacionales sobre practica real y controversias en manejo axilar post-NAC, especialmente diseccion axilar dirigida (TAD) y BSGC con marcaje.

## Recomendaciones clave (resumen)
- Variabilidad internacional importante en abordaje axilar tras NAC; >75% utilizan algun metodo de marcaje del ganglio.
- Consenso emergente: TAD preferida sobre BSGC sola en cN+.
- Identifica controversias persistentes: micrometastasis aisladas y celulas tumorales aisladas tras NAC.
- Apoyo decidido a ensayos clinicos prospectivos (AXSANA/EUBREAST-3).

## Abstract
The aims of this Oncoplastic Breast Consortium and European Breast Cancer Research Association of Surgical Trialists initiative were to identify uncertainties and controversies in axillary management of early breast cancer and to recommend appropriate strategies to address them. By use of Delphi methods, 15 questions were prioritized by more than 250 breast surgeons, patient advocates and radiation oncologists from 60 countries. Subsequently, a global virtual consensus panel considered available data, ongoing studies and resource utilization. It agreed that research should no longer be prioritized for standardization of axillary imaging, de-escalation of axillary surgery in node-positive cancer and risk evaluation of modern surgery and radiotherapy. Instead, expert consensus recommendations for clinical practice should be based on current evidence and updated once results from ongoing studies become available. Research on de-escalation of radiotherapy and identification of the most relevant endpoints in axillary management should encompass a meta-analysis to identify knowledge gaps, followed by a Delphi process to prioritize and a consensus conference to refine recommendations for specific trial designs. Finally, treatment of residual nodal disease after surgery was recommended to be assessed in a prospective register.

## Acceso
Disponible en PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC10752145/

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*Datos de PubMed. Citar: doi 10.1016/j.ctrv.2023.102556*
