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Schneider et al: Axillary lymph node removal for staging cancer; description of a lateral approach and application in 44 tumor-bearing dogs
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Lateral approach to ALN extirpation was successful in 100% of cases (44 dogs, 48 ALNs) with consistent anatomical landmarks (costochondral junction of rib 1 and caudal scapular edge).
  • Median time for ALN removal was 16.6 minutes, highlighting a fast and efficient dissection method.
  • No intraoperative complications were recorded (e.g., hemorrhage or inability to find the lymph node).
  • Postoperative complications occurred in 18% of cases, including seromas (n=2), wound dehiscence (n=4), lameness (n=1), and discomfort (n=1).
  • Histopathology revealed 56% of ALNs had tumor-related pathology, including overt metastases, early metastasis (HN2), or premetastatic changes (HN1).
  • Normal-sized ALNs (<2 cm) still harbored metastases in 22% of cases, emphasizing the unreliability of size as a staging criterion.
  • False negatives in cytology occurred in 4 cases, underlining the limitations of cytologic evaluation for staging.
  • The technique was reproducible without specialized tools, suggesting wide applicability in general and referral practice.

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← Articles

Schneider et al: Axillary lymph node removal for staging cancer; description of a lateral approach and application in 44 tumor-bearing dogs
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Lateral approach to ALN extirpation was successful in 100% of cases (44 dogs, 48 ALNs) with consistent anatomical landmarks (costochondral junction of rib 1 and caudal scapular edge).
  • Median time for ALN removal was 16.6 minutes, highlighting a fast and efficient dissection method.
  • No intraoperative complications were recorded (e.g., hemorrhage or inability to find the lymph node).
  • Postoperative complications occurred in 18% of cases, including seromas (n=2), wound dehiscence (n=4), lameness (n=1), and discomfort (n=1).
  • Histopathology revealed 56% of ALNs had tumor-related pathology, including overt metastases, early metastasis (HN2), or premetastatic changes (HN1).
  • Normal-sized ALNs (<2 cm) still harbored metastases in 22% of cases, emphasizing the unreliability of size as a staging criterion.
  • False negatives in cytology occurred in 4 cases, underlining the limitations of cytologic evaluation for staging.
  • The technique was reproducible without specialized tools, suggesting wide applicability in general and referral practice.

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Multiple Choice Questions on this study

In Schneider 2025 et al., on axillary LN extirpation, what percentage of removed axillary lymph nodes contained tumor-related pathology?

A. 29%
B. 35%
C. 44%
D. 56%
E. 68%

Answer: 56%

Explanation: This includes overt metastasis, early metastasis (HN2), and premetastatic disease (HN1) found on histopathology.
In Schneider 2025 et al., on axillary LN extirpation, which anatomical landmark was critical for reliably locating the axillary lymph node?

A. Cranial border of the scapula
B. Costochondral junction of the first rib
C. Second intercostal space
D. Bicipital groove of the humerus
E. Cranial border of the manubrium

Answer: Costochondral junction of the first rib

Explanation: This landmark served as a consistent reference point in all cases for locating the LN during lateral approach.
In Schneider 2025 et al., on axillary LN extirpation, which statement best reflects the accuracy of cytology for staging ALNs?

A. It is highly sensitive for detecting early metastasis
B. It matched histopathology in all metastatic cases
C. It produced no false negatives
D. It misclassified 4 metastatic nodes as non-metastatic
E. It is the gold standard for nodal staging

Answer: It misclassified 4 metastatic nodes as non-metastatic

Explanation: Four LNs had false-negative cytology but were later confirmed metastatic on histopathology, highlighting limitations of cytology.
In Schneider 2025 et al., on axillary LN extirpation, what was the reported median dissection time for ALN removal alone?

A. 8 minutes
B. 12 minutes
C. 16.6 minutes
D. 22 minutes
E. 30 minutes

Answer: 16.6 minutes

Explanation: Median "skin-to-skin" dissection time was 16.6 minutes, demonstrating the efficiency of this approach.
In Schneider 2025 et al., on axillary LN extirpation, what was a key reason cited for not performing FNA of sentinel ALNs before surgery?

A. Too costly and time-consuming
B. FNA results are always diagnostic
C. Increased anesthesia time
D. To avoid local hemorrhage and contamination of the surgical field
E. FNA requires intraoperative ultrasound

Answer: To avoid local hemorrhage and contamination of the surgical field

Explanation: FNA of sentinel nodes was avoided to maintain surgical clarity and prevent bruising that could obscure LN identification.

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