{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:51:33Z","timestamp":1786679493337,"version":"build-2736575974"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2010,8,26]],"date-time":"2010-08-26T00:00:00Z","timestamp":1282780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The exact anatomical location of the sentinel lymph node (SLN) in the axilla has not ascertained clinically, but could be useful both for teaching purposes and to reduce the morbidity of SLN biopsy. The aim of the study was to determine the position of the SLN in the axilla and to demonstrate that this location is not random.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A consecutive series of 242 patients with stage I breast cancer (T1\/T2 N0) or ductal carcinoma in situ who underwent SLN localization by peritumoral injection were included in a prospective study to map the location of the SLN in the axilla. A new anatomical classification of the lower part of the axilla based on the intersection of two anatomical landmarks, the lateral thoracic vein (LTV) and the second intercostobrachial nerve (ICBN), is described. These two constant elements form the basis of four axillary zones (A, B, C and D).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 98\u00b72 per cent of patients the axillary SLN was located medially, alongside the LTV, either below the second ICBN (zone A, 86\u00b78 per cent) or above it (zone B, 11\u00b75 per cent). In only four patients (1\u00b78 per cent) was the SLN located laterally in the axilla.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Regardless of the site of the tumour in the breast, 98\u00b72 per cent of SLNs were found in the medial part of the axilla, alongside the LTV. This information should help to avoid unnecessary lateral dissections.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7217","type":"journal-article","created":{"date-parts":[[2010,8,30]],"date-time":"2010-08-30T07:20:05Z","timestamp":1283152805000},"page":"1659-1665","source":"Crossref","is-referenced-by-count":85,"title":["New anatomical classification of the axilla with implications for sentinel node biopsy"],"prefix":"10.1093","volume":"97","author":[{"given":"K B","family":"Clough","sequence":"first","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Nasr","sequence":"additional","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Nos","sequence":"additional","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Vieira","sequence":"additional","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Inguenault","sequence":"additional","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Poulet","sequence":"additional","affiliation":[{"name":"The Paris Breast Centre (L'Institut du Sein), 7 Avenue Bugeaud, 75116 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,8,26]]},"reference":[{"key":"2021070910481829900_bib1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s10434-004-1168-y","article-title":"Beyond the clinical trials: how often is sentinel lymph node dissection performed for breast cancer?","volume":"12","author":"Maggard","year":"2005","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib2","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1001\/archsurg.137.10.1131","article-title":"The time has come to change the algorithm for the surgical management of early breast cancer","volume":"137","author":"Hansen","year":"2002","journal-title":"Arch Surg"},{"key":"2021070910481829900_bib3","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1200\/JCO.2000.18.13.2553","article-title":"Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer","volume":"18","author":"Giuliano","year":"2000","journal-title":"J Clin Oncol"},{"key":"2021070910481829900_bib4","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1056\/NEJMoa012782","article-title":"A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer","volume":"349","author":"Veronesi","year":"2003","journal-title":"N Engl J Med"},{"key":"2021070910481829900_bib5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0002-9610(01)00848-0","article-title":"Sentinel lymph node biopsy results in less postoperative morbidity compared with axillary lymph node dissection for breast cancer","volume":"183","author":"Burak","year":"2002","journal-title":"Am J Surg"},{"key":"2021070910481829900_bib6","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1001\/archsurg.138.5.482","article-title":"Relapse and morbidity in patients undergoing sentinel lymph node biopsy alone or with axillary dissection of breast cancer","volume":"138","author":"Blanchard","year":"2003","journal-title":"Arch Surg"},{"key":"2021070910481829900_bib7","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/01.sla.0000149305.23322.3c","article-title":"Axillary recurrence rate in breast cancer patients with negative sentinel lymph node (SLN) or SLN micrometastasis: prospective analysis of 150 patients after SLN biopsy","volume":"241","author":"Langer","year":"2005","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib8","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/01.sla.0000245472.47748.ec","article-title":"Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients","volume":"245","author":"Langer","year":"2007","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib9","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1053\/ejso.2002.1385","article-title":"Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy","volume":"29","author":"Schijven","year":"2003","journal-title":"Eur J Surg Oncol"},{"key":"2021070910481829900_bib10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.ejso.2007.05.017","article-title":"Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: results of the sentinella-GIVOM Italian randomised clinical trial","volume":"34","author":"Del Bianco","year":"2008","journal-title":"Eur J Surg Oncol"},{"key":"2021070910481829900_bib11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.suronc.2006.11.003","article-title":"Lymphoedema following axillary lymph node dissection for breast cancer","volume":"15","author":"Sakorafas","year":"2006","journal-title":"Surg Oncol"},{"key":"2021070910481829900_bib12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.sla.0000129358.80798.62","article-title":"Comparative morbidity of axillary lymph node dissection and the sentinel lymph node technique: implications for patients with breast cancer","volume":"240","author":"Silberman","year":"2004","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib13","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1053\/ejso.2002.1327","article-title":"Shoulder\u2013arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer","volume":"28","author":"Haid","year":"2002","journal-title":"Eur J Surg Oncol"},{"key":"2021070910481829900_bib14","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/jnci\/djj158","article-title":"Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial","volume":"98","author":"Mansel","year":"2006","journal-title":"J Natl Cancer Inst"},{"key":"2021070910481829900_bib15","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1245\/ASO.2006.05.013","article-title":"Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial","volume":"13","author":"Wilke","year":"2006","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib16","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.breast.2007.11.006","article-title":"Fragmentation of axillary fibrofatty tissue during dissection facilitates preservation of the intercostobrachial nerve and the lateral thoracic vein","volume":"17","author":"Ivanovic","year":"2008","journal-title":"Breast"},{"key":"2021070910481829900_bib17","volume-title":"Gray's Anatomy: The Anatomical Basis of Clinical Practice","author":"Stranding","year":"2004","edition":"39th"},{"key":"2021070910481829900_bib18","volume-title":"Clinically Oriented Anatomy","author":"Moore","year":"2006","edition":"5th"},{"key":"2021070910481829900_bib19","volume-title":"Diseases of the Breast","author":"Harris","year":"2004","edition":"3rd"},{"key":"2021070910481829900_bib20","volume-title":"Le Sein. Du Normal au Pathologique: Etat de l'Art","author":"Espi\u00e9","year":"2007","edition":"3rd"},{"key":"2021070910481829900_bib21","volume-title":"Gray's Atlas of Anatomy","author":"Drake","year":"2007","edition":"1st"},{"key":"2021070910481829900_bib22","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00000658-199409000-00015","article-title":"Lymphatic mapping and sentinel lymphadenectomy for breast cancer","volume":"220","author":"Giuliano","year":"1994","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib23","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0960-7404(93)90064-6","article-title":"Surgical resection and radiolocalization of the sentinel node in breast cancer using a gamma probe","volume":"2","author":"Krag","year":"1993","journal-title":"Surg Oncol"},{"key":"2021070910481829900_bib24","doi-asserted-by":"crossref","first-page":"2556","DOI":"10.1245\/s10434-008-9994-y","article-title":"Simplified techniques of radioguided occult lesion localization (ROLL) plus sentinel lymph node biopsy (SNOLL) in breast carcinoma","volume":"15","author":"Lavou\u00e9","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib25","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1245\/s10434-007-9709-9","article-title":"The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: a human cadaver study","volume":"15","author":"Suami","year":"2007","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib26","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/bjs.18004620004","article-title":"The lymphatics of the breast","volume":"46","author":"Turner-Warwick","year":"1959","journal-title":"Br J Surg"},{"key":"2021070910481829900_bib27","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S1072-7515(00)00776-6","article-title":"Anatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy","volume":"192","author":"Tanis","year":"2001","journal-title":"J Am Coll Surg"},{"key":"2021070910481829900_bib28","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/01.sla.0000109156.26378.90","article-title":"Lymphatic drainage patterns from the breast","volume":"239","author":"Estourgie","year":"2004","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib29","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S1470-2045(07)70278-4","article-title":"Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial","volume":"8","author":"Krag","year":"2007","journal-title":"Lancet Oncol"},{"key":"2021070910481829900_bib30","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1002\/1097-0142(1955)8:4<776::AID-CNCR2820080421>3.0.CO;2-B","article-title":"The significance of axillary node levels in the study of breast carcinoma","volume":"8","author":"Berg","year":"1955","journal-title":"Cancer"},{"key":"2021070910481829900_bib31","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1046\/j.1365-2168.1998.00843.x","article-title":"Prospective randomised controlled trial of preservation of the intercostobrachial nerve during axillary node clearance for breast cancer","volume":"85","author":"Abdullah","year":"1998","journal-title":"Br J Surg"},{"key":"2021070910481829900_bib32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1053\/ejso.2002.1409","article-title":"Long term results of a randomised prospective study of preservation of the intercostobrachial nerve","volume":"29","author":"Freeman","year":"2003","journal-title":"EJSO"},{"key":"2021070910481829900_bib33","doi-asserted-by":"crossref","first-page":"195","DOI":"10.2298\/VSP0703195I","article-title":"[Functional effects of preserving the intercostobrachial nerve and the lateral thoracic vein during axillary dissection in breast cancer conservative surgery.]","volume":"64","author":"Ivanovi\u0107","year":"2007","journal-title":"Vojnosanit Pregl"},{"key":"2021070910481829900_bib34","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1245\/s10434-006-9210-x","article-title":"Localization of the sentinel nodes of the upper outer breast quadrant in the axillary quadrants","volume":"14","author":"Pavlista","year":"2007","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib35","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1016\/S0140-6736(05)62634-7","article-title":"Intradermal blue dye to identify sentinel lymph-node in breast cancer","volume":"349","author":"Borgestein","year":"1997","journal-title":"Lancet"},{"key":"2021070910481829900_bib36","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/00000658-200007000-00012","article-title":"Functional lymphatic anatomy for sentinel node biopsy in breast cancer: echoes from the past and the periareolar blue method","volume":"232","author":"Borgstein","year":"2000","journal-title":"Ann Surg"},{"key":"2021070910481829900_bib37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1245\/aso.2002.9.1.77","article-title":"Subareolar injection of 99m-Tc facilitates sentinel lymph node identification","volume":"9","author":"Tuttle","year":"2002","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib38","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1245\/s10434-007-9450-4","article-title":"Blue dye injection in the arm in order to conserve the lymphatic drainage of the arm in breast cancer patients requiring an axillary dissection. A pilot study","volume":"14","author":"Nos","year":"2007","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib39","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1245\/s10434-007-9412-x","article-title":"Axillary reverse mapping (ARM): a new concept to identify and enhance lymphatic preservation","volume":"14","author":"Thompson","year":"2007","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib40","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1002\/jso.20905","article-title":"A new concept toward the prevention of lymphedema: axillary reverse mapping","volume":"97","author":"Klimberg","year":"2008","journal-title":"J Surg Oncol"},{"key":"2021070910481829900_bib41","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.1245\/s10434-008-0030-z","article-title":"Combined axillary reverse mapping (ARM) technique for breast cancer patients requiring axillary dissection","volume":"15","author":"Nos","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"2021070910481829900_bib42","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.jamcollsurg.2007.12.022","article-title":"Axillary reverse mapping: mapping and preserving arm lymphatics may be important in preventing lymphedema during sentinel lymph node biopsy","volume":"206","author":"Boneti","year":"2008","journal-title":"J Am Coll Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.7217","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/97\/11\/1659\/36640498\/bjs7217.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/97\/11\/1659\/36640498\/bjs7217.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T20:16:14Z","timestamp":1625861774000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/97\/11\/1659\/6142167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,8,26]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2010,8,26]]},"published-print":{"date-parts":[[2010,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.7217","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2010,11]]},"published":{"date-parts":[[2010,8,26]]}}}