Background- When radical mastectomy with en bloc resection of the axillary contents was the primary treatment for Breast Cancer(BC), the
existence of discontinuous metastases or the exact knowledge of patterns of spread of axillary lymph node(ALN) metastases was not a major
concern. In the current era where surgical options for BC include incomplete axillary dissections or ALN sampling, this knowledge of lymph node
spread is essential for making appropriate therapeutic decisions.Axillary dissection is an essential component of breast cancer surgery, intending to
control local recurrence and classify the tumor (pN) stage. Hence the present study is undertaken to study level III ALN dissection in operable cases
of breast cancer.
Method- A total of 55 patients underwent Modied Radical Mastectomy (MRM) with complete axillary clearance. Demographic data and
perioperative details, axillary clearance, histopathological evaluation, surgical outcome and complications were noted.
Result- The majority of studies, age group was from 41-50 years (45.45%). Commonest tumor size was 2-5cm (70.91%). The most common stage
was III-A(43.64%). Commonest quadrant was the upper outer (30.91%). Commonest histological type was ductal (94.55%) and grade was grade
II( 61.82%). Average lymph node dissected per case was 14.3. Percentage of patients with level III lymph node involvement is 50.91% and among
them, most common stage –III-A (53.57%), grade- grade II(67.86%), type- ductal (96.43%), quadrant- upper outer (39.29%), tumour size- 2-5cm
(64.29%). Level III “skip metastasis” was found in 1 patient (1.8%).34.5% patients had postoperative pain.
Conclusion- In a low-middle-income country like India, we advocate axillary clearance up to level III in all operable cases of breast cancer with
minimal or no morbidity. However, Randomised Controlled Trials or Meta-analysis should be done for further clearance.
