乳腺癌腋窝手术的降阶梯之路OA

As a pivotal component of breast cancer surgery,axillary procedures are moving toward greater precision and less invasiveness.The goal is to preserve oncologic efficacy while minimizing complications,conserving function,and improving quality of life as possible as we can.Over recent decades,this evolution has followed a clear"de-escalation"trajectory.The realization and evolution of de-escalation are on the basis of a series of clinical trials and the backup provided by systemic therapies,radiotherapy,and so on.This article discuss-es the evolving paradigm and current controversies of axillary de-escalation from five perspectives including the theoretical and practical foundations of de-escalation,the ongoing debate over the Z0011 trial,the omission of sentinel lymph node biopsy,axillary surgeries after neoadjuvant therapy,and the American Society of Clinical Oncology guideline update of 2025.Embracing the shift from"maximum tolera-ble therapy"to"minimum effective therapy"should guide how we interpret,implement,design,and launch future trials,thereby maximizing benefit for every patient.