Extent of Axillary Dissection: How Far Down Should We Dissect?

Axillary lymph node dissection (ALND) is the ‘gold standard’ surgical procedure for the management of metastatic axillary nodes in patients with invasive breast cancer. The procedure involves removal of all the lymph nodes below the inferior border of axillary vein along with fibro-fatty tissue from...

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Bibliographic Details
Published in:Indian journal of surgery 2022-10, Vol.84 (Suppl 3), p.786-788
Main Authors: Sultana, Afrin, Kataria, Kamal, Sharma, Chitresh, Ranjan, Piyush, Dhar, Anita, Srivastava, Anurag
Format: Article
Language:English
Subjects:
Adipose tissues
Breast cancer
Cancer
Cardiac Surgery
Dissection
Lymphatic system
Medicine
Medicine & Public Health
Neurosurgery
Pediatric Surgery
Plastic Surgery
Surgery
Surgical Techniques and Innovations
Thoracic Surgery
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Summary:Axillary lymph node dissection (ALND) is the ‘gold standard’ surgical procedure for the management of metastatic axillary nodes in patients with invasive breast cancer. The procedure involves removal of all the lymph nodes below the inferior border of axillary vein along with fibro-fatty tissue from the axilla preserving important nerves and vessels. Following ALND, histological examination reveals the number of involved lymph node(s) along with findings of any perinodal spread of tumour which is considered a significant prognostic indicator according to the 8th Edition of American Joint Committee on Cancer—AJCC 8th edition. The risk of locoregional and systemic recurrence is determined by the number of positive nodes, the stage of the cancer and the extent of axillary dissection. With complete ALND, the axillary recurrence varies from 0.5 to 2.5% at 10 years. The extent of clearance of axillary tissue in ALND has clearly defined anatomical boundaries all around except for the ‘inferior limit’ of dissection. The surgical literature does not provide a clear guideline regarding the lower border of axillary dissection.
ISSN:0972-2068
0973-9793
DOI:10.1007/s12262-021-03235-w