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Review
. 2021 Mar 29;19(1):93.
doi: 10.1186/s12957-021-02209-2.

New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery

Roberto Cirocchi  1 , Maria Ida Amabile  2 , Alessandro De Luca  3 , Federico Frusone  3 , Domenico Tripodi  3 , Patrizia Gentile  3 , Renata Tabola  4 , Daniele Pironi  3 , Flavio Forte  5 , Massimo Monti  3 , Vito D'Andrea  3 , Salvatore Sorrenti  3
Affiliations
Review

New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery

Roberto Cirocchi et al. World J Surg Oncol. .

Abstract

Background: In the last decade, two research groups, the French group by Clough et al. (Br J Surg. 97:1659-65, 2010) and the Chinese one by Li et al. (ISRN Oncol 2013:279013, 2013), proposed two types of classification of axillary lymph nodes in breast cancer, identifying novel anatomic landmarks for dividing the axillary space in lymph node dissection.

Main body: Knowledge of the exact location of the sentinel node helps to focus the surgical dissection and to reduce the morbidity of sentinel lymph node biopsy procedures, in particular the risk of arm lymphedema, without compromising sensitivity.

Conclusion: In this article, we aimed at focusing on the clinical impact that the most recent classifications of axillary lymph nodes have obtained in literature, highlighting the importance of defining new demarcations to preserve the axillary lymph nodes as much as possible in breast surgery.

Keywords: Axillary lymph node; Breast cancer; Breast surgery; Clough’s classification; Li’s classification; Sentinel lymph node.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The anatomical classification of the axillary lymph nodes (I level, lymph nodes located lateral to the lateral margin of the minor pectoralis muscle; II level, lymph nodes located between the medial and lateral margin of the minor pectoralis muscle and the interpectoral lymph nodes; III level, lymph nodes located medial to the medial margin of the minor pectoralis muscle)
Fig. 2
Fig. 2
Clough’s classification of axillary lymph nodes. The intersection between the lateral thoracic vein (LTV) and the second intercostobrachial nerve (ICBN) forms a cross that creates 4 zones: zone a is the area adjacent to the LTV, extending from the lower border of the axilla to the second ICBN; zone b is the area adjacent to the LTV, extending from the second ICBN to the axillary vein, extending medially under the pectoralis minor muscle; zone c is the lateral axillary area outside zone a; and zone d is the lateral axillary area outside zone b
Fig. 3
Fig. 3
Li’s classification of axillary lymph nodes. The second intercostobrachial nerve (ICBN) divides the axillary space into a lower part (b) and an upper (a) part
See this image and copyright information in PMC

References

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