Axillary Dissection

• Axillary dissection removes lymph nodes from the armpit to stage and treat cancer.
• The procedure involves a surgical incision to carefully remove potentially affected lymph nodes.
• Its primary purpose is to determine cancer spread and prevent local recurrence.
• Recovery involves managing pain, swelling, and potential lymphedema, with varying timelines.
• Post-operative care often includes physical therapy to restore arm mobility and function.

What is Axillary Dissection and Its Purpose?

What is axillary dissection? It is a surgical procedure that involves the removal of a group of lymph nodes from the armpit, also known as the axilla. These lymph nodes are integral to the lymphatic system, which plays a crucial role in the body’s immune defense by filtering waste and housing immune cells. The primary purpose of axillary dissection surgery is to accurately determine if cancer cells have spread from a primary tumor, such as breast cancer or melanoma, to these regional lymph nodes. This information is vital for precise cancer staging, which, in turn, dictates the most appropriate subsequent treatment decisions, including chemotherapy, radiation therapy, and targeted therapies. Beyond diagnosis, the surgery also serves as a therapeutic intervention by removing existing cancerous nodes, thereby aiming to reduce the risk of local cancer recurrence in the axilla. According to the American Cancer Society, lymph node involvement is a key prognostic factor for breast cancer, highlighting the critical importance of this procedure in comprehensive treatment planning and prognosis assessment.

The Axillary Dissection Procedure Explained

The axillary dissection procedure explained typically begins with the patient under general anesthesia. The surgeon makes an incision in the armpit area, usually following the natural skin folds to minimize scarring. Through this incision, the surgeon carefully identifies and removes a significant number of lymph nodes and surrounding fatty tissue from the axilla. The exact number of lymph nodes removed can vary depending on the extent of cancer involvement and the surgeon’s assessment, but it often includes levels I, II, and sometimes III of the axillary lymph nodes. Care is taken to preserve important nerves and blood vessels in the area. Once the lymph nodes are removed, they are sent to a pathology lab for microscopic examination to detect the presence of cancer cells. A drain may be placed in the surgical site to collect any fluid buildup, and the incision is then closed with sutures or surgical staples. The entire procedure usually takes one to two hours.

Axillary Dissection Recovery Time and Care

The axillary dissection recovery time can vary significantly among individuals, typically ranging from a few weeks to several months for full restoration of activity. Immediately after surgery, patients commonly experience pain, swelling, numbness, and a temporary limitation in arm and shoulder movement. Effective pain management with prescribed medications is crucial during the initial recovery phase to ensure comfort and facilitate early mobilization. A surgical drain, if inserted to prevent fluid accumulation, is typically removed within one to two weeks, once the fluid output diminishes. Patients are strongly encouraged to begin gentle arm and shoulder exercises soon after surgery to prevent stiffness and restore range of motion, often under the guidance of a physical therapist or rehabilitation specialist. A significant long-term concern following axillary dissection is lymphedema, a condition characterized by chronic swelling in the arm due to impaired lymphatic drainage. While not everyone develops lymphedema, it is estimated to affect up to 20-30% of patients who undergo axillary dissection, according to studies published in reputable medical journals like the Journal of Clinical Oncology. Patients receive education on strategies to minimize risk, such as avoiding tight clothing, protecting the arm from injury, and performing specific lymphatic drainage exercises. Regular follow-up appointments with the surgical team are essential to monitor healing progress, manage any potential complications, and discuss ongoing care needs.