A D V E R T I S E M E N T

Resection of Solitary Scalene Nodal Breast Cancer Metastasis: 13

A D V E R T I S E M E N T

Dissection of node-bearing tissue was begun at level III (see differential diagnosis of neck masses). All tissue divided was ligated to prevent lymphatic leakage.       

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Resection of Solitary Scalene Nodal Breast Cancer Metastasis: 14

A D V E R T I S E M E N T

The internal jugular vein was encircled with a vessel loop for control. The lymphatic packet, including nodal tissue from level V (posterior triangle), was dissected down toward level IV (suparclavicular), exposing the underlying anterior scalene muscle.       

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Resection of Solitary Scalene Nodal Breast Cancer Metastasis: 15

A D V E R T I S E M E N T

The prevertebral fascia anterior the scalene was opened and the phrenic nerve (at the tip of the clamp) was identified above the tumor.       

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