Locating the axillary vein and preserving the medial pectoral nerve

American Journal of Surgery
Richard A Lopchinsky

Abstract

The exposure for an axillary dissection has become more limited as surgical treatment for breast cancer has evolved from a radical mastectomy to a limited axillary dissection. Exposure of the axillary vein is made more difficult by the smaller incisions, by preservation of intercostobrachial nerves, and by the induration resulting from a previous sentinel node biopsy. To assist in the identification of the axillary vein, I describe the course of a visible but small vein adjacent to the medial pectoral nerve. The vein can be easily identified at the lateral edge of the pectoralis major. It, frequently together with the medial pectoral nerve, traverses in a craniomedial direction and leads to either the lateral thoracic vein (near its junction with the axillary vein) or directly to the axillary vein. Dissection of this vessel identifies the axillary vein, preserves the medial pectoral nerve and allows a more complete and safe level II dissection.

References

Jun 1, 1985·Plastic and Reconstructive Surgery·G R Tobin
Jun 1, 1980·American Journal of Surgery·D A Moosman

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Citations

Apr 19, 2007·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Nebojga IvanovićDarko Babić
Apr 27, 2012·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sylvain DavidBerengere Chignon-Sicard
Dec 29, 2015·Plastic and Reconstructive Surgery·Ana Claudia Weck RoxoRuy Garcia Marques
Dec 29, 2007·The Breast : Official Journal of the European Society of Mastology·N IvanovicS Todorovic
Nov 30, 2011·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Andrea PorzionatoRaffaele De Caro
Oct 13, 2009·São Paulo Medical Journal = Revista Paulista De Medicina·Andrea de Vasconcelos GonçalvesCésar Cabello
Mar 24, 2017·Aesthetic Surgery Journal·Ana Claudia RoxoRuy Garcia Marques

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