چکیده (انگلیسی):

Background: The anatomical orientation of structures in the axilla has not been
well studied, although it is essential for a neat and safe dissection. The objective of this study
was to determine the relations between neurovascular structures in the axilla as they were
encountered during axillary lymph node dissection (ALND) for breast cancer.
Methods: This was a prospective study of 29 consecutive ALNDs accompanying either mastectomy
or wide local excision. The dissections were conducted in a stepwise manner and the
orientation of the structures was determined as the dissections advanced from superficial to
deeper planes.
Results: The medial pectoral pedicle was the most superficial neurovascular structure encountered
during the dissections and was curled around the lateral border of the pectoralis minor
muscle in most cases. The intercostobrachial nerve lay 1e2 cm behind and below, and the axillary
vein was located 2e3 cm behind and above the pedicle. The long thoracic nerve was
constantly found 2e3 cm behind the intercostobrachial nerve. The thoracodorsal nerve was always
accompanied by a posterior tributary of the axillary vein.
Conclusion: Relations between neurovascular structures in the axilla are predictable. The
medial pectoral pedicle, which is consistently found and superficially located, could be used
as a landmark for ALND.