AXILLARY LYMPHADENECTOMY PREPARED BY FAT AND LYMPH-NODE SUCTION IN BREAST-CANCER

Aims. To describe a new technique of axillary dissection and evaluate the results. Methods. Axillary lymphadenectomy prepared by fat and lym ph node suction was performed on 43 patients with breast cancer and un involved axilla on physical examination. The mean follow-up was 18 mon ths (range 12-27). After lipolysis and liposuction of the axilla, lymp h node dissection was performed by axilloscopy in patients treated wit h conservative surgery. For patients undergoing modified radical maste ctomy, a mastectomy with open axillary dissection was carried out. The axillary space was drained until less than 20 mi of lymphorrhea was b eing produced per day. Seventeen modified radical mastectomies (group M) and 26 lumpectomies (group L) were performed. Results. No injury of muscles, vessels or nerves was observed. An average of 13.6 lymph nod es (8-31) were removed. In group L, the mean number of lymph nodes rem oved by liposuction, axilloscopy and control incision was 2.5, 5.4 and 4.2, respectively. In group M, the mean number of lymph nodes removed was 14. None of the 589 lymph nodes examined showed any pathological trauma. Fourteen patients (32%) had more than one histologically posit ive node. The mean quantity of lymphorrhea was 390 mi in group M and 2 75 mi in group L. The mean duration of drainage was 6 days in group M and 5 days in group L. Four patients had seromas which required punctu res. Two patients had shoulder restriction (movements <90 degrees) at 12 months. No arm oedema was seen. Conclusions. Axillary lymphadenecto my prepared by fat and lymph node suction is a reliable and effective procedure. However, it does not appear to be better than standard diss ection as regards post-operative complications, except for arm oedema, but this must be confirmed by further studies.