A patient is found to have a melanoma originating in the skin of the left
forearm. After removal of the tumor from the forearm, all axillary lymph nodes
lateral to the medial edge of the pectoralis minor muscle are removed. Which
axillary nodes would not be removed?
a) Apical lymph nodes
b) Central lymph nodes
c) Lateral lymph nodes
d) Pectoral lymph nodes
Correct Answer - A
The lymph nodes lateral to the LATERAL edge of the pectoralis
minor are the lateral axillary nodes. Pectoral or anterior axillary
nodes are deep to the lateral edge of the pectoralis major muscle.
Central axillary nodes are found directly under pectoralis minor,
while subscapular or posterior axillary nodes are adjacent to the
subscapularis muscle. The apical axillary nodes are medial to the
medial edge of pectoralis minor and so it won’t be removed
evel Part of axilla Lymph nodes
I Low axilla Lymph nodes lateral to the
lateral border of pectoralis
minor(central group,
lateral group, anterior
group, posterior group)
II Mid axilla Lymph nodes between the
lateral and medial borders
of pectoralis minor. plus
interpectoral lymph nodes
III Apical axilla Lymph nodes medial to
medial margin of pectoralis
minor (including
subclavicular,
infraclavicular or apical).