- A physical examination alone:
- Cannot accurately predict the presence of axillary disease
- The accuracy of a physical examination to detect axillary metastasis:
- Ranges from 61% to 68%:
- When compared with resection
- Ranges from 61% to 68%:
- Ultrasonography, magnetic resonance imaging, and positron emission tomography–computed tomography:
- Have all been used to evaluate the axilla:
- And although these imaging modalities may improve on physical examination:
- They are not as accurate as lymphadenectomy for small deposits:
- And have a higher rate of false positives
- They are not as accurate as lymphadenectomy for small deposits:
- And although these imaging modalities may improve on physical examination:
- Have all been used to evaluate the axilla:
- A level I and II axillary lymph node dissection (ALND):
- Has been the gold standard:
- For evaluating the extent of axillary disease
- Unfortunately, the incidences of:
- Lymphedema, chronic pain, seroma development, future cellulitis, numbness, and limits to mobility:
- Are all significant sequelae following ALND
- Lymphedema, chronic pain, seroma development, future cellulitis, numbness, and limits to mobility:
- Has been the gold standard:
- Approximately 70% of patients who are clinically node negative:
- Will have no evidence of disease detected with ALND:
- Putting these patients needlessly at risk for complications
- Will have no evidence of disease detected with ALND:
- In 1991, the technique of sentinel lymph node biopsy (SLNB) was proposed as an alternative to ALND in breast cancer patients:
- The development of SLNB has now replaced ALND:
- As a highly accurate and less morbid axillary staging procedure for most patients
- The development of SLNB has now replaced ALND:
#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #Surgeon #Teacher #BreastCancer #BreastDiseases #AxillaryDissection #BreastSurgery #MountSinaiMedicalCenter #MSMC #Miami #Mexico
Rodrigo Arrangoiz MS, MD, FACS, FSSO 