Sentinel Lymph Node and Axillary Dissection

  • Hisham Fansa
  • Christoph Heitmann


The removal of axillary lymph nodes is nowadays used more for the diagnosis and initiation of adjuvant measures. Surgical therapy can only be one of many approaches to lymph node infiltration caused by cancer. Since the removal of axillary lymph nodes can lead to high morbidity and ultimately the survival rate is not improved by an aggressive lymph node dissection, the removal of sentinel lymph nodes has become popular. The sentinel lymph node (SLN) is the lymph node that is the first filter station in the drainage of the breast. If the lymph node is tumour-free, no further measures are necessary. If the lymph node is affected by macrometastasis, axillary dissection should take place as a follow-up intervention. The frozen section test has proven to be sufficiently safe in our hands. After frozen section examination, the axillary dissection can be performed in the same procedure in case of infiltration. If a frozen section examination is not possible or if a metastasis appears later in the workup, the axillary dissection must be carried out in a second operation. Isolated tumour cells and micrometastases in the SLN are not an indication for axillary lymphadenectomy.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hisham Fansa
    • 1
    • 2
    • 3
  • Christoph Heitmann
    • 4
  1. 1.Department of Plastic, Reconstructive and Aesthetic SurgeryKlinikum BielefeldGermany
  2. 2.Center for Aesthetic Plastic Surgery and Reconstructive Breast SurgeryMunichGermany
  3. 3.Center for Aesthetic Plastic Surgery and Reconstructive Breast SurgeryZurichSwitzerland
  4. 4.Practice for Plastic SurgeryMunichGermany

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