Robot-assisted Axillary Lymph Node Dissection for Axillary Lymph Node Metastasis in Breast Cancer

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Axillary lymph node dissection is critical for staging breast cancer, particularly N2-3 disease.
• Conventional open surgery risks intercostobrachial nerve injury, causing pain and reduced quality of life.
• Robotic-assisted axillary lymph node dissection (R-ALND) offers potential for enhanced precision and fewer complications.

Purpose of the Study:

• To evaluate the safety, efficacy, and outcomes of robotic-assisted axillary lymph node dissection (R-ALND) in breast cancer patients.
• To analyze the technical advantages and perioperative complications associated with R-ALND.
• To assess early recurrence rates following R-ALND.

Main Methods:

• Retrospective analysis of breast cancer patients who underwent R-ALND between March 2024 and March 2025.
• Utilized the da Vinci surgical system with a systematic 'bottom-up, back-to-front' dissection approach.
• Focused on preserving critical structures like the intercostobrachial nerve and blood vessels.

Main Results:

• Mean operative time was 48.16 minutes with minimal blood loss (median 3.00 mL).
• A median of 18 lymph nodes were dissected, with a median of 1 metastatic node identified.
• No perioperative complications (hemorrhage, infection, seroma, etc.) or recurrence were observed during the mean 8.70-month follow-up.

Conclusions:

• R-ALND is a safe and precise method for axillary lymph node dissection in breast cancer.
• The technique leverages 3D visualization and improved instrument maneuverability to minimize complications.
• Further research is needed to validate long-term survival benefits of R-ALND.