[Strategies for management of axillary lymph nodes in breast cancer. Point of view of the Institut Bergonié]

Abstract

Sentinel lymph node biopsy in breast cancer has changed pathology management of axillary lymph nodes by pathologists, but there is still no consensus either for serial sectioning nor for immunohistochemistry. We analyze: 1) data in the literature about the prognostic significance of micrometastases (pNlmi) and immunohistochemically detected infiltrating tumor cells (pN0(i+) in axillary lymph nodes. 2) management strategies at the Bergonié Institute and by other teams for axillary lymph nodes and sentinel lymph nodes. 3) questions and controversies on sentinel lymph node management and recommendations of the five main reference groups.