Muscular Variations During Axillary Dissection: A Clinical Study in Fifty Patients

Abstract

Aim: The present study was conducted to detect the musculature variations during axillary dissection for breast cancer surgery.
Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year.
Results: In a period of one year, two patients (4%) with axillary arch and one patient (2%) with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified.
Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer.

Key Words: Axillae, Pectoralis major muscle, Pectoralis minor muscle, Breast surgery, muscle variations, Dissection, Langer’s Arch