虽然哨兵淋巴结活检现在是腋窝分期的主要方法，对于只有少量淋巴结病变的患者来说，这种方法也有治疗效果。但是，在那些还没有证实哨兵淋巴结活检准确度的病例和重度腋窝肿瘤负担的患者中，仍需进行腋窝淋巴结清扫（ALND）来进行分期评估和控制局部病变。此外，针对风险水平量身定制的新型系统治疗手段有时需要了解涉及到的腋窝淋巴结数量，这只能通过进行ALND来获得。正在进行的试验将探讨在哪些情况下放射治疗可以替代ALND。版权所有©2023 Elsevier Ltd.。

Although sentinel lymph node biopsy is now the primary method of axillary staging and is therapeutic for patients with limited nodal disease, axillary lymph node dissection (ALND) is still necessary for staging in groups where sentinel lymph node biopsy has not been proven to be accurate and to maintain local control in those with a heavy axillary tumor burden. Additionally, newer approaches to systemic therapy tailored to risk level sometimes necessitate knowledge of the number of involved axillary nodes which can only be obtained with ALND. Ongoing trials will address whether there are additional circumstances where radiotherapy can replace ALND.Copyright © 2023. Published by Elsevier Ltd.