The Level of Axillary Clearance in Breast Conserving Surgery for Breast Cancer Treatment | International Journal of Medical Sciences And Clinical Research

Authors

Mustafa Adnan Jaafar

M.B.Ch.B., F.I.B.M.S.
Abdulrazzaq Kalaf Hassan

M.B.Ch.B., F.I.C.M.S., C.A.B.S., Department of general surgery, Karbala University / collage of medicine, Iraq

DOI:

https://doi.org/10.37547/ijmscr/Volume06Issue07-04

Keywords:

Breast cancer axillary dissection level of axillary dissection

Abstract

Background: Breast cancer is the most common cancer in women and is the leading cancer death in women aged 20 to 59 years. Mastectomy and breast conserving surgery (BCS) are the major elements for treating such conditions, beside lymph node dissection (lymphadenectomy) at different axillary levels with other treatment like chemotherapy, radio therapy and hormonal therapy.

Objectives: The feasibility of minimizing axillary dissection in the treatment of breast cancer with an optimal oncological outcome and low mortality.

Methods: A prospective analytic study was adopted over a period of twelve months from March the 1st, 2021 till March the 1st, 2022.Then patients were observed after surgery till October the 1st ,2022. Data was collected from patients who were diagnosed to have breast cancer and treated at Imam Al-Hussein medical city, Safeer Al-Imam Al-Hussein hospital and Al-Kafeel hospital in Karbala, Iraq. The prognostic factor was the number of positive lymph nodes that are removed at each level and their correlation to other study variables.

Results: the mean age of the study group was 53.2 years, and the number of cases collected were 70. Thirty nine patients had mastectomy and 31 had breast conserving surgery. Most of the patients were at stage II of the disease identified during surgery and the axillary lymph nodes dissection were performed at different levels. The number of positive lymph nodes after axillary dissection was not related to the level of axillary dissection.

Conclusions: level I axillary dissection (limited axillary lymph nodes dissection) is recommended in the treatment of early breast cancer with synergistic effect of neoadjuvant chemoradiotherapy, since the number of positive lymph nodes are not increased with extensive axillary dissection, further dissection is recommended when there are multiple masses, higher stage or grade of the disease and or big mass larger than 5cm.

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