Management of Axilla in Breast Cancer: Reducing Morbidity of Axillary Dissection

Abstract

The main role of axillary dissection for breast cancer is in deciding the nature of adjuvant therapy. Its role in improving overall survival is still not proven. Lymphedema is the most dreaded morbidity of axillary dissection. While sentinel node biopsy may help reduce this considerably, this is possibly more applicable in countries that have a regular screening program and plenty of screen-detected cancers. In India, we get most patients with palpable lumps and palpable axillary nodes are not uncommon. In such situations, axillary dissection is mandatory. We look at the ways to reduce the morbidity of lymphedema that we currently apply and also look at the newer techniques like axillary reverse mapping being tried to lessen this morbidity.

Keywords: Breast cancer, lymphedema, axillary reverse mapping, sentinel node