“De-escalating management of primary and locally recurrent  breast cancer”

Until recently, all patients with recurrent breast cancer were treated with an axillary gland dissection as standard. This is an extensive operation on the lymph nodes in the armpit with a high risk of postoperative complaints. The sentinel node procedure is a less invasive, alternative option and the standard treatment for patients with primary breast cancer. In the Sentinel Node And Recurrent Breast Cancer (SNARB) study, the applicability of a repeated sentinel node procedure was investigated and observed in patients with a local recurrence of breast cancer. But is this procedure safe? What if the procedure fails? And does the intervention have any impact on, for example, the chance of metastases? All patients were followed over time. Small a small percentage developed a recurrence in the glands around the breast. This means that the execution of the repeated sentinel gland procedure is safe, which makes standard execution of the armpit gland dissection unnecessary. Subsequently, the outcome of a repeated sentinel node procedure (positive, negative of an unsuccessful procedure) was considered to have an influence on the development of metastases in the elderly. This is not to be. It seems that the standard removal of the sentinel gland for returned breast cancer is unnecessary in the future. All steps we take to make the treatment of breast cancer for women less and less invasive -> de-escalation of surgery.