Behind The Knife: The Surgery Podcast Behind the Knife ABSITE 2026 - Breast
Jan 3, 2026
Explore the intricacies of axillary node levels and the nerves at risk during dissection. Learn about breast blood supply and the implications of Batson's plexus. Delve into the management of conditions like Mondor's disease and fibrocystic disease. Understand the evaluation of atypical hyperplasia and the nuances of DCIS treatment. Discover the challenges of breast cancer in pregnancy and essential aspects of breast conservation therapy. Quick hits on chemotherapy indications and reconstruction options round out this informative discussion.
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Axillary Dissection Levels
- When performing an axillary lymph node dissection for breast cancer, remove levels I and II (lateral and posterior to pectoralis minor).
- For melanoma nodal dissection include levels I–III when indicated.
Nerves To Protect In The Axilla
- Protect nerves during axillary dissection: the long thoracic, thoracodorsal, and intercostobrachial nerves.
- Expect serratus anterior winging, latissimus weakness, or medial-arm sensory loss if injured.
Why Breast Cancer Reaches The Spine
- Breast venous drainage includes Batson's valveless plexus which permits direct hematogenous spread to the spine.
- This explains vertebral metastases outside typical lymphatic routes.