Are supero-lateral group of nodes affected in axilla in breast cancer? A validation study

Abstract

Introduction: ALND is a standard intervention for high volume axillary disease. The arm lymphatics are indistinguishable from breast-lymphatics and are sacrificed in non-targeted dissection. Based on literature review and our experience with ICG-guided-ARM, we hypothesized that superolateral group nodes drain arm lymphatics exclusively. Preservation of the lymph nodes and lymphatics in this zone can reduce lymphedema. The axillary nodes are divided into groups in relation to three anatomical landmarks (thoracodorsal pedicle, 2nd intercostobrachial nerve and pectoralis-minor muscle).