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Related Concept Videos

Detailed Structure and Function of Lymph Nodes01:23

Detailed Structure and Function of Lymph Nodes

Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...

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Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
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Published on: April 3, 2026

A positive intramammary lymph node does not mandate a complete axillary node dissection.

Ricardo Diaz1, Amy C Degnim, Judy C Boughey

  • 1Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.

American Journal of Surgery
|July 27, 2011
PubMed
Summary
This summary is machine-generated.

A positive intramammary lymph node (IMLN) with a negative axillary sentinel lymph node (SLN) biopsy accurately stages the axilla. Complete axillary lymph node dissection (CALND) can be safely avoided in these cases.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Management

Background:

  • The role of axillary staging in breast cancer is critical.
  • Intramammary lymph nodes (IMLN) can be involved even when axillary sentinel lymph nodes (SLN) are negative.
  • The necessity of complete axillary lymph node dissection (CALND) in such scenarios is debated.

Purpose of the Study:

  • To evaluate if a negative axillary SLN biopsy reliably stages the axilla in patients with a positive IMLN.
  • To determine if CALND can be omitted when IMLN is positive and SLN is negative.

Main Methods:

  • Comprehensive literature search for studies involving IMLNs and SLN biopsies.
  • Inclusion of patients with positive IMLN, negative SLN, and subsequent CALND.
  • Review of institutional database for similar patient cases.

Main Results:

  • Twenty-one cases from literature and two from the institutional database were identified.
  • All 23 patients had a positive IMLN and a negative axillary SLN biopsy.
  • None of the patients who underwent CALND had positive axillary nodes.

Conclusions:

  • Axillary SLN biopsy is a reliable indicator of axillary disease status, even with a positive IMLN.
  • CALND can be safely avoided in patients presenting with a positive IMLN and a negative axillary SLN biopsy.
  • This finding supports de-escalation of axillary surgery in select breast cancer patients.