ArticleAnnals of surgical oncology2026
Axillary Lymph Node Dissection Through a Separate Incision Does Not Increase Rates of Breast Cancer-Related Lymphedema.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
backgroundBreast cancer patients treated with axillary lymph node dissection (ALND) have an approximate 20-30% lifetime risk of developing lymphedema, with multiple factors implicated in the pathogenesis. In patients undergoing mastectomy, ALND can be performed through the mastectomy incision or through a separate axillary incision. It is unknown whether the latter causes more lymphatic disruption resulting in higher lymphedema rates. We aimed to assess whether ALND through the mastectomy incision versus a separate incision impacts rates of breast cancer-related lymphedema (BCRL).
methodsA retrospective chart review was performed of patients who underwent mastectomy and ALND from 2017 to 2020. Patients were grouped by ALND via mastectomy or a separate incision. The primary outcome of interest was development of BCRL as defined by ICD-10 codes.
resultsA total of 1,036 patients were included; 483 via a separate axillary incision and 553 underwent ALND via the mastectomy incision. Median time to lymphedema development was 15 months. The BCRL rates between patients who had ALND via a separate incision were not significantly different from those who had ALND via the mastectomy incision (29 vs. 30%, p = 0.77). Multivariable logistical regression showed patients with ALND performed through a separate incision did not have significantly greater odds of developing lymphedema compared with those with ALND performed through the mastectomy incision (odds ratio 0.89; 95% confidence interval 0.65-1.21; p = 0.45).
conclusionsPatients who received ALND via a separate axillary incision as compared to the mastectomy incision do not have significantly greater rates of BCRL. Oncologic safety should be prioritized when considering lymph node retrieval technique.
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