Breast Surgeons Live

 Back to Activities List

Session Title:
Management of the Axilla
Date & Time:
January 16, 2024, 7:00 PM–8:00 PM ET
1 Hour
CME Deadline:
January 16, 2025
Log in to access members-only content.
Target Audience:
Surgeons with a special interest in the treatment of breast disease.
At the end of this activity, participants will be able to:
  • Define the best options of preoperative axillary imaging and which patients with breast cancer benefit from imaging.
  • Explain the surgical and non-surgical approaches to managing the clinically positive axilla at presentation and after neoadjuvant chemotherapy.
  • Classify patients with breast cancer for whom axillary surgery can be avoided completely without affecting cancer outcomes.
Management of the axilla remains a topic of ongoing debate and evolution. This webinar will review the current literature, standard of care, as well as state of the art practice.
Welcome and Introduction
Kandace McGuire, MD, FACS
Preop Imaging of the Axilla: Who Needs It and How Should It Be Performed
Michael Alvarado, MD, FACS
Management of Patients With Positive Nodes at Presentation and/or After Neoadjuvant Chemotherapy. How Do We De-escalate Axillary Surgery While Maximizing Outcomes?
Kandace McGuire, MD, FACS
Avoiding SLNB From Delayed SLNB to Choosing Wisely
Stephanie Valente, DO, FACS
Moderator—Kandace P. McGuire, MD, FACS
Professor of Surgery
Chief of Breast Surgery
VCU Massey Cancer Center
Richmond, VA
Michael Alvarado, MD, FACS
University of California, San Francisco
San Francisco, CA
Stephanie Valente, DO, FACS
Cleveland Clinic
Cleveland, OH
  1. Giuliano AE, Ballman KV, McCall L, et al. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA. 2017;318(10):918–926. doi: 10.1001/jama.2017.11470
  2. Boughey JC, Suman VJ, Mittendorf EA, et al. Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy in Patients With Node-Positive Breast Cancer: The ACOSOG Z1071 (Alliance) Clinical Trial. JAMA. 2013;310(14):1455–1461. doi:10.1001/jama.2013.278932
  3. Caudle AS, Yang WT, Krishnamurthy S, Mittendorf EA, Black DM, Gilcrease MZ, Bedrosian I, Hobbs BP, DeSnyder SM, Hwang RF, Adrada BE, Shaitelman SF, Chavez-MacGregor M, Smith BD, Candelaria RP, Babiera GV, Dogan BE, Santiago L, Hunt KK, Kuerer HM. Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection. J Clin Oncol. 2016 Apr 1;34(10):1072-8. doi: 10.1200/JCO.2015.64.0094. Epub 2016 Jan 25. PMID: 26811528; PMCID: PMC4933133.
  4. Karakatsanis A, Hersi AF, Pistiolis L, Olofsson Bagge R, Lykoudis PM, Eriksson S, Wärnberg F; SentiNot Trialists Group. Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study). Br J Surg. 2019 May;106(6):720-728. doi: 10.1002/bjs.11110. Epub 2019 Mar 6. PMID: 30839104.
  5. Chang JM, Leung JWT, Moy L, Ha SM, Moon WK. Axillary Nodal Evaluation in Breast Cancer: State of the Art. Radiology. 2020 Jun;295(3):500-515. doi: 10.1148/radiol.2020192534. Epub 2020 Apr 21. PMID: 32315268.
Use the link below to view disclosure information for all individuals and groups involved in the planning, implementation, and evaluation of this educational activity.
View Disclosure Information (pdf)