What is Axillary Dissection?

Axillary dissection (also called axillary lymph node dissection) is a surgical procedure that removes lymph nodes from the armpit (axilla). It is performed to check for the spread of breast cancer and to prevent further spread.

Indications for Axillary Dissection

Axillary dissection may be recommended if:

• Cancer has spread to lymph nodes detected via biopsy.

• Sentinel lymph node biopsy shows cancer cells.

• The tumour is large, with a high risk of lymph node involvement.

• There is recurrent breast cancer affecting lymph nodes.

Surgical Technique

• The procedure is performed under general anesthesia.

• An incision is made in the armpit.

• Several lymph nodes (typically 10 -30) are removed.

• The area is examined for any remaining cancerous tissue.

• Drains may be placed to remove excess fluid.

• The incision is closed with internal stitches.

Lymphoedema Following Axillary Dissection

Lymphoedema occurs in approximately 15-25% of patients after axillary dissection. Radiotherapy to the axilla can increase the risk and severity of symptoms.

Prevention and Management of Lymphedema

• Prevention:

  • Avoid injuries, cuts, or infections on the affected arm.

  • Maintain a healthy weight and avoid excessive heat exposure.

  • Engage in gentle arm exercises to promote lymph drainage.

  • Avoid heavy lifting and prolonged pressure on the arm.

• Treatment:

  • Physiotherapy: Manual lymphatic drainage and therapeutic exercises can help improve fluid circulation and prevent worsening symptoms.

  • Occupational Therapy: Training in daily activities and adaptive techniques to reduce strain on the affected arm.

  • Compression Garments: Special sleeves can help reduce swelling and improve lymphatic flow.

  • Lifestyle Modifications: Staying active, maintaining a balanced diet, and avoiding prolonged immobility can help manage symptoms.

  • Medical Interventions: In some severe cases, additional treatments like lymphatic bypass surgery may be needed.

Post-Operative Care

• You will stay in hospital overnight.

• Pain management includes prescribed painkillers or over-the-counter medication.

• Avoid heavy lifting for a few weeks.

• Gentle arm exercises may be recommended to prevent stiffness.

• Follow-up appointments are essential to monitor healing and detect complications.