Vol. 3, Issue 1, Part F (2019)

Background and Objective: In order to perform sentinel lymph node biopsy and axillary lymph node dissection successfully during breast cancer surgery, it is crucial to accurately identify the axillary lymphatic drainage channels. Surgical success, staging precision, and recurrence hazards are all affected by lymphatic anatomical variations. The purpose of this research is to examine the differences in anatomy between breast cancer patients' axillary lymphatic drainage and the difficulties and successes of surgical procedures, taking into account new findings from patents on imaging, mapping, and surgical methods.

Materials and Methods: The research took place between April 2018 and March 2019 at the Madha Medical College and Hospital's Department of General Surgery in Chennai, Tamil Nadu, India. For this prospective study, researchers examined the anatomy and clinical data of 40 breast cancer patients who were having their axillary lymph nodes examined. Imaging was enhanced with high-resolution MRI and indocyanine green fluorescence, and intraoperative lymphatic mapping was carried out utilizing dual-tracer procedures including radioisotope and blue dye. The differences in anatomy were categorized and documented. Forty patents pertaining to advancements in lymphatic mapping, surgical device, and axillary dissection were compiled after a thorough examination of patents in three worldwide databases (USPTO, WIPO, and EPO).

Results: Classic axillary drainage was seen in 68% of the patients, while 32% had unusual pathways such as interpectoral (17%), internal mammary (9%), and supraclavicular (6%). A higher body mass index and tumor closeness to the upper outer quadrant were substantially linked with anomalies. The detection accuracy of sentinel lymph nodes was lowered in atypical anatomy, although the overall rate of identification was 96%. Technologies such as image-guided lymph node biopsy, robotic axillary dissection, lymphatic-specific contrast agents, and fluorescence-guided surgery have the potential to improve detection while decreasing false negatives, according to the included patents.

Conclusion: Clinically substantial anatomical difference in axillary lymphatic drainage may impact surgical decision-making in breast cancer. Improved accuracy in lymph node appraisal and subsequent better results can be achieved by the integration of cutting-edge mapping technologies with proprietary surgical advances. Surgeons can improve treatment techniques by being alert to potential drainage irregularities and using imaging-guided planning.