Abstract
Introduction: In the setup of breast cancer management, axillary lymph node clearance plays a role in staging and planning of adjuvant chemotherapy and local control of cancer. Harvesting minimum of 10 lymph nodes for histopathological analysis is cut off value to consider a 90% certainty of a true negative axillary lymph node after axillary clearance.
 Aim: To assess the adequacy of axillary lymph node clearance considering influence of tumor factor (size, site, grade, type, lymphovascular invasion and hormonal and HER 2-NEU receptor status).
 Method: Retrospective analysis of histopathological report included 117 patients underwent mastectomy and axillary lymph node clearance from January 2011 to July 2016 in professorial surgical unit teaching hospital Jaffna. The analysis assessed the adequacy of the axillary lymph node clearance considering the influence of tumor factor.
 Results: Adequate axillary lymph node clearance was done in 89.7% (105). None of considered factors showed significance influence (p<0.05) except tumor type.
 Conclusion: Unit achieved desirable adequacy in axillary lymph node clearance, clearance adequacy is not associated with considered tumor factors except tumor type.
 Keywords: Axillary lymphnode clearance, Adequacy, Breast cancer, nodal status
Highlights
Introduction: In the setup of breast cancer management, axillary lymph node clearance plays a role in staging and planning of adjuvant chemotherapy and local control of cancer
The number of the axillary lymph node cleared was compared with recommended numbers in term of adequacy, considering association of tumor factor
More than 10 lymph nodes were harvested in 105 patients; 89.7% of the patients had an adequate axillary node clearance according to the recommended standards
Summary
In the setup of breast cancer management, axillary lymph node clearance plays a role in staging and planning of adjuvant chemotherapy and local control of cancer. The analysis assessed the adequacy of the axillary lymph node clearance considering the influence of tumor factor. Axillary lymph node clearance provides an important prognostic information that influences the management decisions[3,4,12,13]. Our unit adopted a policy in the background of the studies [14-18] that Minimum of ten lymph nodes is required in the axillary clearance specimen to provide accurate information for staging. In this recommendation, it is determined that retrieval of ten axillary lymph nodes is the cut off value to consider a 90% certainty of a true negative axillary status [10]. Even though our unit carries out axillary clearance, the current recommendation for axillary sampling - sentinel node biopsy (not available in our unit) is having less morbidity compare to axillary lymph node clearance
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