Patterns of Axillary Lymph Node Metastasis from Breast Cancer in Egyptian Patients

Treatment of the axilla by surgery with or without radiotherapy remains an integral part of the management of patients with invasive breast cancer. In general, the standard treatment of the axilla involves axillary lymph node dissection (ALND) in which surgical clearance of axillary nodes with a minimum of level I & II is performed. ALND is an effective staging procedure and is essential for local control of the disease in the axilla. The ability of a level I/II dissection to provide adequate regional control in a group of patients, who already have a 32% rate of pretreatment level III nodal metastases, is of great concern. A less complete axillary procedure is associated with a higher rate of axillary failure [1,26]. Level III dissection is probably superior to radiotherapy in preventing axillary relapse which is a miserable condition that is difficult to treat [9,11].