Learn how UpToDate can help you.

Select the option that best describes you

Technique of axillary lymph node dissection
Technique of axillary lymph node dissection
Author:
Julie Margenthaler, MD
Section Editor:
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Deputy Editor:
Wenliang Chen, MD, PhD
Literature review current through: Mar 2024.
This topic last updated: Jul 01, 2022.

INTRODUCTION

Evaluation of the axilla provides information for treatment decisions in patients with invasive breast cancer. Axillary lymph node dissection (ALND) is the standard initial approach for breast cancer patients who are clinically node positive. Sentinel node biopsy is the standard initial approach for patients with early-stage breast cancer who are clinically node negative.

The technique of ALND will be reviewed here. The approach to management of the regional lymph nodes in breast cancer, sentinel node biopsy indications and outcomes, sentinel node biopsy techniques, and effect of ALND on patient survival are discussed elsewhere. (See "Overview of management of the regional lymph nodes in breast cancer" and "Overview of sentinel lymph node biopsy in breast cancer" and "Sentinel lymph node biopsy in breast cancer: Techniques".)

INDICATIONS

An axillary lymph node dissection (ALND) is performed with the primary breast procedure (eg, lumpectomy or mastectomy) in patients who have:

●Locally advanced (T3-T4; N0-2) or inflammatory breast cancer. (See "Overview of sentinel lymph node biopsy in breast cancer", section on 'Contraindications'.)

●Needle-biopsy-proven metastatic disease in axillary lymph node(s), which are either clinically palpable or nonpalpable but abnormal by imaging (mostly ultrasound) criteria. (See "Overview of sentinel lymph node biopsy in breast cancer", section on 'Preoperative axilla evaluation'.)

Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.