Transaxillary breast augmentation: The impact on axillary lymphatic drainage and sentinel lymph node evaluation

Abstract

Currently, alternative incisions for breast augmentation have been described, and among the techniques available, the axillary approach has gained status as an attractive technique due to the aesthetic results and the scar placement in a less visible position. However, the future impact of the procedure on the lymphatic drainage patterns and sentinel lymph node (SLN) detection remains controversial. To date little information is available regarding the feasibility of SLN identification in patients with previous transaxillary breast augmentation. The results of our studies and the lymphatic pattern observed suggest that the lymphatic breast drainage is more similar to a rich and extended network than to a few lymph trunks. According to some authors, based on oncological surgeries, even in the situation where this lymphatic channel is disrupted, due to the presence of a variable network of flexible lymphatics, the SLN has the potential to be mapped. However, additional long-term studies are necessary to investigate the accuracy of SLN biopsy in subgroups of breast cancer patients with previous breast implants.