What anatomical structures are preserved during axillary lymph node dissection (ALND) for breast cancer?

In axillary lymph node dissection (ALND) for breast cancer, the preservation of key neurovascular structures is crucial for postoperative recovery and maintaining arm functionality. During ALND, surgeons aim to remove the lymph nodes involved in the cancer while minimizing damage to nearby structures, particularly the nerves and blood vessels that are vital for normal arm movement and sensation.

Key neurovascular structures in the axilla include the long thoracic nerve, which innervates the serratus anterior muscle, and the thoracodorsal nerve, which supplies the latissimus dorsi muscle. Preserving these nerves helps prevent complications like shoulder dysfunction or winged scapula, which can occur if the long thoracic nerve is damaged.

While other options mention various lymph node levels or the chest wall, the focus during ALND is on ensuring that critical neurovascular components remain intact. This is essential for enhancing patient quality of life post-surgery and reducing the risk of complications associated with nerve damage.