Axillary Management of Carcinoma Breast

Case Report

Abstract

We present the case of a 52-year-old female, who presented to us with a lump in the (L) breast. She is premenopausal, married with three children.

The case is not very different from the other patients who present with breast lump and when investigated, confirmed to be carcinoma and they received treatment as per the guidelines and patient reference. But as it is the most recent case in our series of operated carcinoma breast, we have taken it as a case study to review the axillary treatment in carcinoma breast, being practiced by most breast surgeons.

The axilla was negative clinically and on usg with only five lymph nodes seen in the axilla of size 1.8x0.9 cm with preserved hilum.

The enlarged lymph nodes were identified as sentinel lymph node with methylene blue injections and taken for biopsy.

The patient had a relatively large breast, where conservation of breast surgery was a good option but the patient considering all the options wanted to go for total mastectomy.

The patient also considered the advantages of axillary LN dissection and decided to go for radiotherapy in case a sentinel lymph node biopsy shows metastatic deposits.

The patient was taken up for left total mastectomy, with sentinel lymph node biopsy. The lymph node enlargement was reactive. The lymph node biopsy showed no metastatic deposits. Biopsy of the breast lump showed infiltrating lobular carcinoma with clear margins. Four other lymph nodes sent, along with the above large LN, were found to be disease-free. Patient was referred for Radiotherapy to Oncology.