Women with tumors of less than 2 cm in diameter and one or two affected lymph nodes could avoid complete excision of the axillary lymph nodes.
Based on the current scientific evidence and the recommendations of international clinical guidelines, the Spanish Association of Breast Surgeons (AECIMA) considers that it is now possible to stop performing lymphadenectomies in a selected group of patients with metastatic involvement of the sentinel lymph node. This decision has to be made on a case-by-case basis and in a multidisciplinary setting.
During the I AECIMA National Conference, held last March in San Sebastian, a consensus was reached regarding a proposal for the selection of women with metastatic involvement of the sentinel lymph node, who could potentially avoid lymphadenectomy. This group would include women meeting all of the following criteria: tumors of less than 2 cm in diameter (T1); involvement of 1-2 sentinel lymph nodes (micro or macrometastases); and breast-conserbing surgery.
The exclusion criteria for this option are: patients who underwent mastectomy or had 3 or more affected sentinel lymph nodes; extracapsular invasion of the sentinel lymph node; impossibility of undergoing post-operative radiation therapy; or presence of tumors of triple negative subtype.
Document approved after the I AECIMA Conference, April 2012.