Axillary lymph nodes surgical levels

Case contributed by Rasha ElQaffas
Diagnosis certain

Presentation

Known case of right breast carcinoma

Patient Data

Age: 40 years
Gender: Female

Biopsy-proven right breast carcinoma showing pathological ipsilateral level I, II, and III axillary lymph nodes (divided by pectoralis minor muscle). Mediastinal and supraclavicular lymph nodes are also noted.

Case Discussion

Surgical levels of axillary lymph nodes are defined by their relation to the pectoralis minor muscle:

  • level I: lateral to the pectoralis minor muscle

  • level II: posterior to the pectoralis minor muscle (including interpectoral lymph nodes, also known as Rotter node)

  • level III: medial to the pectoralis minor muscle

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