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Axillary lymph node dissection

What is an axillary lymph node dissection?

The lymph nodes are essential for fighting off infection, and thus when they are swollen, it indicates infection in the body. Lymph nodes also carry the infected cells. An axillary lymph node dissection is a surgical procedure in which the axilla (armpit) is dissected, and the lymph nodes are removed in order to test for abnormal cells. This surgery is also done as a treatment for breast cancer.

There are three levels of lymph nodes in the armpit each below on another. If Dr Noorbhai believes that the cancer has spread to the lymph nodes, he may want to remove up to 30 nodes during the surgery. By seeing how, many of the nodes are affected by the cancer will be an indication of how severe the cancer is.

How is an axillary lymph node dissection done?

Once under general anaesthesia, Dr Noorbhai will make an incision under the arm, in the armpit and remove the lymph nodes. The lymph nodes and surrounding tissue are then sent to the laboratory to be tested. A drainage tube and bag are put into place for excess fluids. The incision is then closed with absorbable stitches or surgical staples. The drainage tube is left in place for a few weeks.

  • antibiotics to prevent infection
  • pain-relieving medicine
  • instructions on caring for and dressing the wound
  • information about how to manage the drainage bag and tube
  • advice on how much and which types of activity you can do after surgery
  • instructions on what to wear
  • advice on the best positions for your arm
  • a follow-up appointment to see the surgeon in 1–2 weeks
  • information about which symptoms and side effects you should report

Why would an axillary lymph node dissection be done?

An axillary lymph node dissection is done to remove cancer-ridden lymph nodes, see how cancerous the lymph nodes are and see whether the cancer has spread. It is also done to check if cancer cells are in the lymph nodes at all and if not removed to prevent cancer from spreading to the lymph nodes. They are also removed to reduce the risk of reoccurring cancer.

How long will I be in hospital?

Most patients spend one night in hospital after surgery, and they are able to go home. How soon you will be discharged from hospital depends on whether you are able to drink liquids when waking up, how much pain you have and whether you have someone to look after you at home.

What will happen after my axillary lymph node dissection?

After surgery, you will be given instructions on how to care for your wound. You will be given pain medication and antibiotics to prevent infection, and you will be advised on shoulder and arm exercises to do to reduce swelling. You will also be told how to manage the drainage tube. Following surgery you may experience the following:

  • Shoulder and arm pain.
  • Tingling or burning in the wound area.
  • Weakness in your arm and shoulder.
  • Difficulty moving your arm and shoulder.
  • Red skin around your wounds.

All these symptoms are normal and are nothing to be concerned about, and your voice should return to normal in a few days. Re-consult if you have an unusually high temperature, chills, vomiting, swelling around the incisions, bleeding from the wound, you are experiencing excessive pain or pain behind the knee or groin as emergency care may be needed. Approximately 3 weeks after your operation you will be seen by your surgeon to check your wounds.

How soon after the surgery can I resume normal activities?

You will be able to resume normal activities soon after your surgery; however, it is important to start slowly. If you experience pain during a certain activities, stop that activity. You may not do any heavy lifting or vigorous physical activity for at least 3-6 weeks after surgery.

What are the potential risks and complications of an axillary lymph node dissection?

The risk of complications during surgery is very low; however, there are risks involved in any surgery, and the following complications can occur:

  • Infection of the wound or internal infection.
  • Bleeding.
  • Fluid build-up.
  • Risks from general anaesthetic.
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