【摘 要】
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Background: In order to reduce the probability of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operati
【机 构】
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Alexandria University Egypt
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Background: In order to reduce the probability of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operative procedure.So partial axillary dissection has been applied to decrease the morbidity and postoperative axillary complications.Aim of the work was to study the reliability of partial axillary lymph nodes dissection in patients with breast carcinoma with clinical negative axilla Methods: Eighteen patients performed modified radical mastectomy, while the other two patients who were fulfilling the criteria for conservative breast surgery underwent lumpectomy.All patients did complete axiilary lymph nodes dissection.Intraoperative leveling of the axilla was performed and level Ⅰ axillary lymph nodes was identified according to its relation to pectoralis minor muscle;then it was subjected to intraoperative pathological examination by frozen section examination followed by complete axillary clearance.Then post operative histopathological examination of the tumor and all lymph nodes was done.Results: By intraoperative pathological examination; five patients (25%) were found positive for malignant invasion, while 15 patients (75%) were pathologically free.While paraffin section showed six patients (30%) with malignant invasion, and 14 patients (70%) were pathologically free.There was a false negative rate of 5% in level Ⅰ axillary lymph nodes by intraoperative pathological examination which was positive for metastasis by paraffin section that revealed microinvasion in one lymph node out of eight in level Ⅰ.Only two cases out of twenty were found positive for metastasis in level Ⅱ and Ⅲ.Conclusion: Partial axillary lymph node dissection is a minimally invasive, feasible and sufficient technique that can predict the axillary lymph nodes status.Abbreviation: LN: lymph node, RT: radiotherapy, IDC: invasive ductal carcinoma.
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