الفهرس 
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Abstract
The status of the regional lymph node remains the most powerful predictor of survival in women with invasive breast cancer, and this status is used for enrolment in adjuvant protocols and to make treatment decisions. Recent suggestions have been made to eliminate axillary node dissection from the , general treatment of women with breast cancer, since most if not all women of invasive breast cancer receive some form of adjuvant therapy. Because of the importance of regional lymph node status, it makes sense to continue to perform an axillary staging procedure. However, axillary nodal dissection may be associated with significant morbidity, including the need for general anesthesia, postoperative lymphedema of the involved extremity, neuropathy of the arm, seroma formation, formation of painful neuroma, or local wound problems. These complications are associated with increased hospitalization, increased overall costs, and considerable discomfort to the patient. Developing techniques that make axillary procedures more conservative and less morbid will improve patient care. . Determination of axillary nodal status is essential for staging of breast cancer. However the extend of axillary dissection required for accurate staging is controversial. Total dissection of the axilla has the highest morbidity but offers the greatest staging accuracy (Shaw and Rumball, 1990). The accuracy of limited dissections or sampling procedures is unclear, partially because these procedures often are ill defmed and partially because of the methods used to evaluate their accuracy. Difference in staging techniques are best described by kinne,.1993 Sampling is the removal of an axillary node or nodes from the lower axilla without defining precise anatomical boundaries. Low axillary dissection is an en block excision of level I Lymph nodes, defined anatomically as lymph nodes medial to the latissimus dorsi muscle and extending to the lateral border