A Better Understanding of Axillary Lymph Node Dissection in the Era of Sentinel Lymph Node Biopsy

Axillary lymph node dissection (ALND) was and still is an important part of breast cancer treatment despite the fact the sentinel lymph node biopsy (SLNB) has revolutionized breast cancer surgery. SLNB provides the same prognostic information as ALND but with significantly less morbidity. The results of numerous trials conducted over the past 20 years have crowned SLNB as the gold standard for early breast cancer treatment. ALND represents a very standardized intervention with precise landmarks and boundaries. An accurate technique and a good knowledge of axillaâÃÂàanatomy are mandatory for a correct and complete ALND. But even with a meticulous and careful technique of dissection, a comprehensive ALND may be associated with important morbidity. Nowadays ALND indications are continuously evolving, but the procedure has still an indisputable place in breast cancer treatment.