- Author: K. B. Clough, R. Nasr, C. Nos, M. Vieira, C. Inguenault, B. Poulet
- Published: Aug 26, 2010
- Pages: 1659-1665
- DOI: 10.1002/bjs.7217
Abstract
Background:
The exact anatomical location of the sentinel lymph node
(SLN) in the axilla has not ascertained clinically, but could be
useful both for teaching purposes and to reduce the
morbidity of SLN biopsy. The aim of the study was to determine the
position
of the SLN in the axilla and to demonstrate that this
location is not random.
Methods:
A consecutive series of 242 patients with stage I breast cancer (T1/T2 N0) or ductal carcinoma in situ
who underwent SLN localization by peritumoral injection were included
in a prospective study to map the location of the SLN
in the axilla. A new anatomical classification of the
lower part of the axilla based on the intersection of two anatomical
landmarks, the lateral thoracic vein (LTV) and the second
intercostobrachial nerve (ICBN), is described. These two constant
elements form the basis of four axillary zones (A, B, C
and D).
Results:
In 98·2 per cent of patients the axillary SLN was located
medially, alongside the LTV, either below the second ICBN (zone
A, 86·8 per cent) or above it (zone B, 11·5 per cent). In
only four patients (1·8 per cent) was the SLN located laterally
in the axilla.
Conclusion:
Regardless of the site of the tumour in the breast, 98·2
per cent of SLNs were found in the medial part of the axilla, alongside
the LTV. This information should help to avoid
unnecessary lateral dissections. Copyright © 2010 British Journal of
Surgery
Society Ltd. Published by John Wiley & Sons, Ltd.
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