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Table 1 Surgical technique

From: Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation

Surgical Technique Description
Radical Mastectomy (RM) Elipsoid incision including the skin portion to be removed. Preparation of the posterior and the anterior strip of skin, followed by breast gland removal in toto, including the neoplasm, with the respect of pectoral fascia.
Quadrantectomy (Qu) Diamond shape incision, including the tumor cutaneus projection in the middle. Removal of the breast gland until the fascial plan of the underlying muscle. The lateral thickness of removed healthy gland must be at least 1 cm from the neoplasm
Axillary Lymph Node Dissection (ALND) Incision up the skin projection of the large dorsal muscle (extension of the ellipsoid excision when associated to RM, separate excision when associated to Qu). Preparation of the posterior and anterior strip of the skin, lax tissue removal until the axillary vein, section of intercostobrachial nerve. Identification of the dorsal bundle (arthery, vein, nerve) and the thoracic nerve (N. of Bell) that must be preserved (I level). Expostion and section of the pectoralis minor, in order to access the underlying lymphonodes (II level). Identification of the subclavian tendon and subclavian vein, exciding the lax tissue until the medial edge of the pectoralis minor previously sectioned (III level)