Endoscopic axillary lymphadenectomy after liposuction.

In breast cancer treatment axillary lymphadenectomy remains essential and necessary because of its role in prognosis and in treatment. Lymphatic nodal involvement is the most important finding for prognosis and indicates the necessity of adjuvant chemotherapy. Axillary lymphadenectomy decreases the risk of local and/or regional recurrence, but it does not modify the survival rate. Unfortunately, axillary lymphadenectomy has a high morbidity rate, despite all improvements made in the last decades. The conventional surgical technique removes the intact axillary content, preserving large vascular and nervous elements, but destroys a certain amount of small arteries, veins, lymphatics and nerves. This leads to complications such as lymphorrhea and edema, hypoaesthesia, shoulder stiffness, pain, deformity of the axilla, long and unaesthetic scars and the most disabling of all, arm swelling.