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Radial access is the most frequent procedure for a single port in breast-conserving surgery because the high frequency of tumors in this anatomical area. The planning of this access is made through a radial incision of 4-5 cms located in the equator of the breast. The location of this incision should be as close as possible to the armpit because SNB is a more complex procedure in its execution than lumpectomy. For this we have different options depending on the location of the tumor with respect to the equator of the breast, although we must prioritize an incision that facilitates axillary lymph node staging.
The planning of the incision in the radial access will depend on the location of the tumor and the location of the mammary equator. The ideal situation is the coincidence of the tumor in the equatorial line because it facilitates its direct resection (A). When this does not happen, the incision on the mammary equator becomes a gateway for tumor resection by tunneling to different points of the upper breast pole (B, C, D). In these cases the location of the incision should be prioritized in the access to the armpit since the SNB will be the most complex procedure in this approach
In most patients, the mobilization of the breast towards the axilla allows us to calculate the distance at which we will place the incision during the dissection of the axillary tunnel.
The following video shows a radial access and remodeling for the removal of a multifocal tumor