Axillary Node Dissection

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Level 1

  • nodes lateral to pectoralis minor
  • involved in 58% of Ca breast patients

Level 2

  • nodes behind pectoralis minor
  • Involved with level 1 in 22% of breast Ca patients
    • 4-25% of patients had skip lesions

Level 3

  • nodes medial to pectoralis minor
  • nodal involvement occurs in <3-16% of patients

Use

  • reduced recurrence rates after level 1and 2 clearance
  • level 3 clearance adds little to reduce recurrence but increases morbidity

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