MUltimodal Targeted Axillary Surgery
MUltimodal Targeted Axillary Surgery
The present trial will prospectively evaluate the accuracy of both a systematic predefined
 axillary ultrasound imaging together with tumor load quantification of suspicious and
 sentinel axillary lymph nodes to predict overall tumor load in the axilla.
Axillary node clearance (ANC) is a controversial intervention in the surgical treatment of
 breast cancer. Different studies have shown that in some patients with infiltrated axillary
 lymph nodes but low tumor burden, ANC can be safely omitted. However, indications for ANC
 persist in nowadays for patients with positive axillary lymph nodes and upfront surgery and
 patients with positive lymph nodes after neoadjuvant treatment. The present prospective study
 will evaluate the ability to establish an axillary tumor load with two steps. The first step
 will be a preoperative predefined systematic axillary ultrasound imaging workflow. The second
 step will be the tumor load evaluation of suspicious and sentinel axillary lymph nodes. We
 will also evaluate which patients have infiltrated nodes only beneath the second
 intercostobrachial nerve. The trial intends to identify patients for who a complete axillary
 node clearance could be spared.
Inclusion Criteria:

 -  Node-positive breast cancer patients confirmed by biopsy or cytology

 -  Positivity confirmed before the surgical treatment

 Exclusion Criteria:

 -  Inability to confirm positive lymph nodes by biopsy or cytology

 -  Inability to understand the protocol design

 -  Poor understanding of the Spanish language