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Peer-reviewedCC BYCureus

Completion Axillary Lymph Node Dissection (cALND) in Residual Axillary Disease After Modified Radical Mastectomy

  • Shantanu Tyagi1
  • Mohim Thakur1
  • Mridul Khanna2
  • Anshul Sharma3
  • Anilkumar Chongtham4
4 affiliations
  1. 1General Surgery, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
  2. 2Medical Oncology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
  3. 3Nuclear Medicine, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
  4. 4Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Abstract

Residual axillary disease after an incomplete axillary lymph node dissection in breast cancer poses a management challenge. We report a 46-year-old female with left breast invasive ductal carcinoma who presented two months after modified radical mastectomy with bulky residual axillary nodes. PET-CT revealed metabolically active nodes suspicious for metastasis. After multidisciplinary discussion, completion axillary lymph node dissection (cALND) was performed, yielding two metastatic nodes out of six. The postoperative course was uneventful, and the patient proceeded to systemic therapy. For limited residual disease, regional nodal irradiation plus systemic therapy may achieve comparable local control with reduced morbidity, whereas bulky disease may justify surgical clearance for accurate staging and local control. This case highlights the role of cALND in young patients with significant residual nodal disease, emphasizing individualized, multidisciplinary decision-making based on disease burden, radiation quality, and systemic therapy.

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Cite

BibTeXRIS
BibTeX
@article{tyagi2026completion,
  title = {{Completion Axillary Lymph Node Dissection (cALND) in Residual Axillary Disease After Modified Radical Mastectomy}},
  author = {Shantanu Tyagi and Mohim Thakur and Mridul Khanna and Anshul Sharma and Anilkumar Chongtham},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.117391},
  url = {https://europepmc.org/article/PMC/PMC13726538},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Completion Axillary Lymph Node Dissection (cALND) in Residual Axillary Disease After Modified Radical Mastectomy
AU  - Shantanu Tyagi
AU  - Mohim Thakur
AU  - Mridul Khanna
AU  - Anshul Sharma
AU  - Anilkumar Chongtham
PY  - 2026
DA  - 2026/10/03
JO  - Cureus
DO  - 10.7759/cureus.117391
UR  - https://europepmc.org/article/PMC/PMC13726538
AB  - Residual axillary disease after an incomplete axillary lymph node dissection in breast cancer poses a management challenge. We report a 46-year-old female with left breast invasive ductal carcinoma who presented two months after modified radical mastectomy with bulky residual axillary nodes. PET-CT revealed metabolically active nodes suspicious for metastasis. After multidisciplinary discussion, completion axillary lymph node dissection (cALND) was performed, yielding two metastatic nodes out of six. The postoperative course was uneventful, and the patient proceeded to systemic therapy. For limited residual disease, regional nodal irradiation plus systemic therapy may achieve comparable local control with reduced morbidity, whereas bulky disease may justify surgical clearance for accurate staging and local control. This case highlights the role of cALND in young patients with significant residual nodal disease, emphasizing individualized, multidisciplinary decision-making based on disease burden, radiation quality, and systemic therapy.
SN  - 2168-8184
ER  -