The first reaction is “how long can I live” and the second reaction is “get me a clean cut”. At present, the main surgical methods for breast cancer include breast-conserving surgery, simple mastectomy, modified radical mastectomy, radical mastectomy, extended radical mastectomy, and so on. Regardless of the surgical method, the key is how to weigh the pros and cons between the best treatment effect and the least complications! At the same time, regardless of the surgical approach, it is important to clarify whether there is axillary lymph node metastasis. This is because clarification of the axillary lymph nodes is crucial to the evaluation of the disease, the choice of surgical approach, and the choice of postoperative treatment. People used to think that “the more you cut, the better the outcome of breast cancer treatment”. But it turns out that this is not the case at all! After years of clinical exploration, it was found that breast cancer is a systemic disease from the beginning of the disease, that is to say, the metastasis of the whole body has already started from the time the tumor appears. It is not helpful to cut the local area more than necessary! Instead of prolonging the patient’s survival, over-extending the surgery leads to a significant increase in mortality and post-operative complications! If the axillary lymph nodes have metastases, they need to be completely cleared; if the axillary lymph nodes do not have cancer metastases, they do not need to be cleared, otherwise the chance of developing postoperative limitation of movement of the affected upper limb or even upper limb edema will be significantly increased. How to know whether the axillary lymph nodes have metastasized? This is where the “sentinel lymph nodes” need to be detected. The so-called “outpost” is the “sentry”, and the “axillary lymph nodes” are the “barracks”. The “sentinel” is the forefront of the “barracks”, if the “sentinel” is violated, the “barracks” may also be If the “sentinel” is not violated, the “barracks” can be considered safe. To determine whether the sentinel lymph node is metastatic, preoperative imaging (ultrasound, mammography, MRI, etc.), physician’s physical examination, and puncture biopsy can be used. However, the most reliable method is sentinel lymph node biopsy. The lymph nodes are about the same color as the surrounding fat in the body, and the trauma that comes with that is absolutely intolerable if you cut and turn to find them. This requires the use of a method to make it appear different from other tissues. Nowadays, tracing is mostly done using dye methods, nuclear tracer methods, or a combination of both. When these tracers are injected into the breast, blue-stained lymphatic vessels and lymph nodes can be seen, or nuclei can be detected concentrated in the lymph nodes using specialized instruments, and when they are found, they are cut out and sent for examination, and the results are known in half an hour. If the patient does not show any lymph node metastasis in the axilla, and the doctor recommends “modified radical breast cancer surgery”, it means that the doctor’s knowledge and surgical technique are at least 20 years behind. Either he doesn’t know how to do such “sentinel lymph node biopsy”, or he is trying to save time. But this kind of thing still can not be saved, normal human tissue is useful, should not be cut! After reading the above article, you only need to know the following concepts: 1. The larger the scope of breast cancer surgery, the better. 2. Biopsy of anterior lymph nodes is very important to guide the next surgical approach, and lymph nodes that do not need to be cleared should not be cleared.