Breast cancer is the second most commonly diagnosed malignancy and the leading cause of cancer-related mortality among women, according to the GLOBOCAN 2022 [1]. Axillary lymph node metastasis (ALNM) represents a critical prognostic factor and plays a pivotal role in guiding surgical and therapeutic decision-making [2]. Although axillary lymph node dissection (ALND) has traditionally served both diagnostic and therapeutic purposes, its associated morbidities—including lymphedema and nerve injury…