COMPLETE AXILLARY DISSECTION: A TECHNIQUE THAT STILL HAS RELEVANCE IN CONTEMPORARY MANAGEMENT OF BREAST CANCER
Identifieur interne : 007D22 ( Main/Exploration ); précédent : 007D21; suivant : 007D23COMPLETE AXILLARY DISSECTION: A TECHNIQUE THAT STILL HAS RELEVANCE IN CONTEMPORARY MANAGEMENT OF BREAST CANCER
Auteurs : Owen Ung [Australie] ; Mona Tan [Australie] ; Boon Chua [Australie] ; Bruce Barraclough [Australie]Source :
- ANZ Journal of Surgery [ 1445-1433 ] ; 2006-06.
Abstract
Axillary lymph node status is an important prognostic indicator for women with breast cancer and axillary dissection provides accurate information regarding nodal status. In addition, local control of axillary disease and allocation of adjuvant systemic therapy are dependent on appropriate axillary surgery. The survival benefit of an axillary dissection remains controversial. We describe a technique of complete axillary clearance that includes levels I, II and III. In our experience this technique is associated with no additional morbidity to patients and incurs minimal prolongation of operative time compared with a level II dissection. Other operative descriptions of axillary surgery generally do not adequately describe a method that clearly and consistently identifies the boundaries, anatomical landmarks and neurovascular structures that traverse the axilla. This technique, with relative ease, allows the identification and preservation of these structures in their original anatomical planes and avoids the division of the pectoralis minor muscle. The assumption that routine level III axillary clearance, as opposed to level I or level II dissection, is associated with greater morbidity warrants further evaluation. No well‐conducted randomized trials have addressed this issue.
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DOI: 10.1111/j.1445-2197.2006.03765.x
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In addition, local control of axillary disease and allocation of adjuvant systemic therapy are dependent on appropriate axillary surgery. The survival benefit of an axillary dissection remains controversial. We describe a technique of complete axillary clearance that includes levels I, II and III. In our experience this technique is associated with no additional morbidity to patients and incurs minimal prolongation of operative time compared with a level II dissection. Other operative descriptions of axillary surgery generally do not adequately describe a method that clearly and consistently identifies the boundaries, anatomical landmarks and neurovascular structures that traverse the axilla. This technique, with relative ease, allows the identification and preservation of these structures in their original anatomical planes and avoids the division of the pectoralis minor muscle. The assumption that routine level III axillary clearance, as opposed to level I or level II dissection, is associated with greater morbidity warrants further evaluation. No well‐conducted randomized trials have addressed this issue.</div></front></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Ung, Owen" sort="Ung, Owen" uniqKey="Ung O" first="Owen" last="Ung">Owen Ung</name></noRegion><name sortKey="Barraclough, Bruce" sort="Barraclough, Bruce" uniqKey="Barraclough B" first="Bruce" last="Barraclough">Bruce Barraclough</name><name sortKey="Chua, Boon" sort="Chua, Boon" uniqKey="Chua B" first="Boon" last="Chua">Boon Chua</name><name sortKey="Tan, Mona" sort="Tan, Mona" uniqKey="Tan M" first="Mona" last="Tan">Mona Tan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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