New anatomical classification of the axilla with implications for sentinel node biopsy
Identifieur interne : 003425 ( Istex/Corpus ); précédent : 003424; suivant : 003426New anatomical classification of the axilla with implications for sentinel node biopsy
Auteurs : K. B. Clough ; R. Nasr ; C. Nos ; M. Vieira ; C. Inguenault ; B. PouletSource :
- British Journal of Surgery [ 0007-1323 ] ; 2010-11.
Abstract
The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.
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DOI: 10.1002/bjs.7217
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ISTEX:6FA77CD2C9A947A7972926046163F3907081C5BFLe document en format XML
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Clough</name><affiliation><mods:affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, Franc</mods:affiliation></affiliation></author><author><name sortKey="Nasr, R" sort="Nasr, R" uniqKey="Nasr R" first="R." last="Nasr">R. Nasr</name><affiliation><mods:affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Nos, C" sort="Nos, C" uniqKey="Nos C" first="C." last="Nos">C. Nos</name><affiliation><mods:affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Vieira, M" sort="Vieira, M" uniqKey="Vieira M" first="M." last="Vieira">M. 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Poulet</name><affiliation><mods:affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Surgery</title><title level="j" type="alt">BRITISH JOURNAL OF SURGERY</title><idno type="ISSN">0007-1323</idno><idno type="eISSN">1365-2168</idno><imprint><biblScope unit="vol">97</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1659">1659</biblScope><biblScope unit="page" to="1665">1665</biblScope><biblScope unit="page-count">7</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2010-11">2010-11</date></imprint><idno type="ISSN">0007-1323</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-1323</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>node</json:string><json:string>axillary</json:string><json:string>axilla</json:string><json:string>surg</json:string><json:string>quadrant</json:string><json:string>morbidity</json:string><json:string>tumour</json:string><json:string>breast cancer</json:string><json:string>oncol</json:string><json:string>icbn</json:string><json:string>surg oncol</json:string><json:string>lymphatic</json:string><json:string>british journal</json:string><json:string>slns</json:string><json:string>medial</json:string><json:string>clough</json:string><json:string>alnd</json:string><json:string>second icbn</json:string><json:string>sentinel node</json:string><json:string>sentinel</json:string><json:string>lateral</json:string><json:string>present study</json:string><json:string>biopsy</json:string><json:string>axillary dissection</json:string><json:string>john wiley sons</json:string><json:string>surgery society</json:string><json:string>intercostobrachial</json:string><json:string>thoracic</json:string><json:string>lymph</json:string><json:string>tracer</json:string><json:string>lymphoedema</json:string><json:string>lower part</json:string><json:string>sentinel node biopsy</json:string><json:string>sentinel lymph node biopsy</json:string><json:string>lateral thoracic vein</json:string><json:string>axillary zones</json:string><json:string>dissection</json:string><json:string>second intercostobrachial nerve</json:string><json:string>lateral axillary area</json:string><json:string>sentinel lymph node</json:string><json:string>lymphatic drainage</json:string><json:string>intercostobrachial nerve</json:string><json:string>nanocolloid tracer</json:string><json:string>breast cancer patients</json:string><json:string>axillary lymph node dissection</json:string><json:string>axillary vein</json:string><json:string>carcinoma</json:string><json:string>breast</json:string><json:string>medial part</json:string><json:string>anatomical landmarks</json:string><json:string>teaching purposes</json:string><json:string>operable breast cancer</json:string><json:string>ductal carcinoma</json:string><json:string>breast carcinoma</json:string></teeft></keywords><author><json:item><name>K. 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B.</forename><surname>Clough</surname></persName><email>krishna.clough@orange.fr</email><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, Franc</affiliation></author><author xml:id="author-0001"><persName><forename type="first">R.</forename><surname>Nasr</surname></persName><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">C.</forename><surname>Nos</surname></persName><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">M.</forename><surname>Vieira</surname></persName><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">C.</forename><surname>Inguenault</surname></persName><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">B.</forename><surname>Poulet</surname></persName><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France<address><country key="FR"></country></address></affiliation></author><idno type="istex">6FA77CD2C9A947A7972926046163F3907081C5BF</idno><idno type="DOI">10.1002/bjs.7217</idno><idno type="unit">BJS7217</idno><idno type="toTypesetVersion">file:BJS.BJS7217.pdf</idno></analytic><monogr><title level="j" type="main">British Journal of Surgery</title><title level="j" type="alt">BRITISH JOURNAL OF SURGERY</title><idno type="pISSN">0007-1323</idno><idno type="eISSN">1365-2168</idno><idno type="book-DOI">10.1002/(ISSN)1365-2168</idno><idno type="book-part-DOI">10.1002/bjs.v97:11</idno><idno type="product">BJS</idno><imprint><biblScope unit="vol">97</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1659">1659</biblScope><biblScope unit="page" to="1665">1665</biblScope><biblScope unit="page-count">7</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2010-11"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background:
<p>The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.</p>
Methods:
<p>A consecutive series of 242 patients with stage I breast cancer (T1/T2 N0) or ductal carcinoma <hi rend="italic">in situ</hi> who underwent SLN localization by peritumoral injection were included in a prospective study to map the location of the SLN in the axilla. A new anatomical classification of the lower part of the axilla based on the intersection of two anatomical landmarks, the lateral thoracic vein (LTV) and the second intercostobrachial nerve (ICBN), is described. These two constant elements form the basis of four axillary zones (A, B, C and D).</p>
Results:
<p>In 98·2 per cent of patients the axillary SLN was located medially, alongside the LTV, either below the second ICBN (zone A, 86·8 per cent) or above it (zone B, 11·5 per cent). In only four patients (1·8 per cent) was the SLN located laterally in the axilla.</p>
Conclusion:
<p>Regardless of the site of the tumour in the breast, 98·2 per cent of SLNs were found in the medial part of the axilla, alongside the LTV. This information should help to avoid unnecessary lateral dissections. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></abstract><abstract xml:lang="en" style="short"><p>Predictable location of sentinel nodes</p></abstract><textClass><classCode scheme="articleCategory">Original Article</classCode><classCode scheme="tocHeading1">Original Articles</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/6FA77CD2C9A947A7972926046163F3907081C5BF/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Ltd.</publisherName><publisherLoc>Chichester, UK</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1365-2168</doi><issn type="print">0007-1323</issn><issn type="electronic">1365-2168</issn><idGroup><id type="product" value="BJS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="BRITISH JOURNAL OF SURGERY">British Journal of Surgery</title><title type="short">Br J Surg</title></titleGroup></publicationMeta><publicationMeta level="part" position="110"><doi origin="wiley" registered="yes">10.1002/bjs.v97:11</doi><numberingGroup><numbering type="journalVolume" number="97">97</numbering><numbering type="journalIssue">11</numbering></numberingGroup><coverDate startDate="2010-11">November 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="100" status="forIssue"><doi origin="wiley" registered="yes">10.1002/bjs.7217</doi><idGroup><id type="unit" value="BJS7217"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 British Journal of Surgery Society Ltd. 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B.</givenNames><familyName>Clough</familyName></personName><contactDetails><email>krishna.clough@orange.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>R.</givenNames><familyName>Nasr</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>C.</givenNames><familyName>Nos</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>M.</givenNames><familyName>Vieira</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>C.</givenNames><familyName>Inguenault</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>B.</givenNames><familyName>Poulet</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background:</title><p>The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.</p></section><section xml:id="abs1-2"><title type="main">Methods:</title><p>A consecutive series of 242 patients with stage I breast cancer (T1/T2 N0) or ductal carcinoma <i>in situ</i> who underwent SLN localization by peritumoral injection were included in a prospective study to map the location of the SLN in the axilla. A new anatomical classification of the lower part of the axilla based on the intersection of two anatomical landmarks, the lateral thoracic vein (LTV) and the second intercostobrachial nerve (ICBN), is described. These two constant elements form the basis of four axillary zones (A, B, C and D).</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>In 98·2 per cent of patients the axillary SLN was located medially, alongside the LTV, either below the second ICBN (zone A, 86·8 per cent) or above it (zone B, 11·5 per cent). In only four patients (1·8 per cent) was the SLN located laterally in the axilla.</p></section><section xml:id="abs1-4"><title type="main">Conclusion:</title><p>Regardless of the site of the tumour in the breast, 98·2 per cent of SLNs were found in the medial part of the axilla, alongside the LTV. This information should help to avoid unnecessary lateral dissections. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></section></abstract><abstract type="short" xml:lang="en"><p>Predictable location of sentinel nodes</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>New anatomical classification of the axilla with implications for sentinel node biopsy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Location of the sentinel node in the axilla</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>New anatomical classification of the axilla with implications for sentinel node biopsy</title></titleInfo><name type="personal"><namePart type="given">K. B.</namePart><namePart type="family">Clough</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, Franc</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R.</namePart><namePart type="family">Nasr</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Nos</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Vieira</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Inguenault</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Poulet</namePart><affiliation>The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-11</dateIssued><dateValid encoding="w3cdtf">2010-06-02</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">5</extent><extent unit="tables">2</extent><extent unit="references">42</extent></physicalDescription><abstract>The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.</abstract><abstract>A consecutive series of 242 patients with stage I breast cancer (T1/T2 N0) or ductal carcinoma in situ who underwent SLN localization by peritumoral injection were included in a prospective study to map the location of the SLN in the axilla. A new anatomical classification of the lower part of the axilla based on the intersection of two anatomical landmarks, the lateral thoracic vein (LTV) and the second intercostobrachial nerve (ICBN), is described. These two constant elements form the basis of four axillary zones (A, B, C and D).</abstract><abstract>In 98·2 per cent of patients the axillary SLN was located medially, alongside the LTV, either below the second ICBN (zone A, 86·8 per cent) or above it (zone B, 11·5 per cent). In only four patients (1·8 per cent) was the SLN located laterally in the axilla.</abstract><abstract>Regardless of the site of the tumour in the breast, 98·2 per cent of SLNs were found in the medial part of the axilla, alongside the LTV. This information should help to avoid unnecessary lateral dissections. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</abstract><abstract type="short" lang="en">Predictable location of sentinel nodes</abstract><relatedItem type="host"><titleInfo><title>British Journal of Surgery</title></titleInfo><titleInfo type="abbreviated"><title>Br J Surg</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0007-1323</identifier><identifier type="eISSN">1365-2168</identifier><identifier type="DOI">10.1002/(ISSN)1365-2168</identifier><identifier type="PublisherID">BJS</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>97</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1659</start><end>1665</end><total>7</total></extent></part></relatedItem><identifier type="istex">6FA77CD2C9A947A7972926046163F3907081C5BF</identifier><identifier type="DOI">10.1002/bjs.7217</identifier><identifier type="ArticleID">BJS7217</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 British Journal of Surgery Society Ltd. 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