Complete Removal of Small Foci of Breast Cancer Metastases to the Axillary Lymph Node by Core Needle Biopsy

The clinical or pathological status of the axilla is an essential component for staging in patients with breast cancer. Since lymph node positivity increases the stage of the disease and changes treatment strategies, lymph node (LN) sampling should be done.۱ Pre-operatively, ultrasound (US) or US-guided biopsy should be performed in clinically suspicious lymph nodes to help determine the axillary surgery method.۲,۳,۴ In the vast majority of patients, sentinel lymph node dissection (SLND) is the procedure of choice. Axillary Nymph Node Dissection (ALND) may not be indicated if the positive LN number is less than ۳ in luminal type breast cancers in this subgroup and if there were more than ۳ positive LNs, ALND should be added to the surgery protocol along with radiotherapy (RT) of the lymphatic bed. Having information about the lymph node can also change the plan of surgery in triple-negative and HER۲-enriched breast cancers that are a candidate for neoadjuvant chemotherapy. If the LNs are positive and the patient receives neoadjuvant chemotherapy, the lymph nodes are examined intraoperatively. In cases with positive residual LN after NAC, ALND should be applied in addition to radiotherapy.۱,۵,۶