Rosa Di Micco, MD, PhD, from San Raffaele Scientific and Research Hospital in Milan, Italy, discusses the evolving role of axillary surgery in breast cancer treatment, particularly in the context of neoadjuvant chemotherapy. While axillary surgery has traditionally served as a staging procedure, its relevance has come into question, especially concerning cases of isolated tumor cells (ITC) or micrometastases found in sentinel nodes. Dr Di Micco emphasizes that patients with these findings tend to have a prognosis similar to those with node-negative status, suggesting that axillary dissection may offer limited therapeutic benefits. Moreover, ongoing studies like the observational AXSANA trial (NCT04373655) indicate a decrease in the incidence of ITC or micrometastases, raising the question of the necessity of completion axillary dissection in cases with low tumor burden. Ultimately, she advocates for a tailored approach to axillary surgery, weighing the diagnostic and therapeutic implications for individual patients. This interview took place at the ESSO 43 Congress in Antwerp, Belgium.
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