Biopsy of the sentinel lymph node and the possibility of performing breast-conserving surgery for the non-inflammatory invasive breast cancers with edema

Breast cancer (BC), accompanied by edema, is one of the most aggressive forms of malignant neoplasms. The gold standard for the treatment of breast cancer with skin edema (T4bN any M0) is a complex method, including neoadjuvant drug therapy fol-lowed by radical mastectomy, postoperative radiation therapy and, if indicated, adjuvant drug therapy. Based on a study of the medical literature and our clinical experience, we concluded that it is possible to identify a group of patients with limited skin swelling and favourable clinical and morphological prognostic factors who can undergo de-escalation of surgical intervention. De-escala-tion is possible in the form of reducing the volume of lymphadenectomy using the sentinel lymph node biopsy technique, as well as performing breast-conserving surgery and skin-sparing mastectomies with reconstruction. © 2025 Elsevier B.V., All rights reserved.