The lymphatics from most of the breast drain into the axilla except for the medial quadrant which may drain into the internal mammary node as well. The presence of lymph node metastasis, tumor dimensions, and histological grade continue to be the most important prognostic indicators even in the molecular era. Axillary staging is therefore an integral part of management of breast cancer treatment. Traditionally axillary lymph node dissection involves removing all three levels of axillary lymph nodes. The procedure provides staging, prognostic information, and locoregional control but carries a significant morbidity that includes shoulder stiffness, possible damage to medial pectoral nerve, long thoracic nerve, and neurovascular pedicle of the latissimus dorsi, along with a significant risk of lymphedema. Surgical staging is still the gold standard for the axilla because none of the nonoperative imaging modalities have proven as effective as surgical staging.
KeywordsSentinel Lymph Node Sentinel Lymph Node Biopsy Axillary Lymph Node Axillary Lymph Node Dissection Latissimus Dorsi
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