What is breast cancer?

Breast cancer is a harmful growth that starts in the glandular tissue of your breast.

Lymph nodes (glands) are small structures which lie along lymph vessels present throughout the body. They help the body deal with infections, but they also become involved in the spread of some cancers.

Sometimes breast cancer spreads to one or more lymph nodes in the armpit on the same side. Axillary node clearance is an operation to remove all the lymph nodes from the affected armpit.

What are the benefits of surgery?

Some lymph nodes in the armpit may appear normal but contain cancer cells. Removing all of the lymph nodes in the armpit gives the best chance of clearing the cancer cells from this area.

The lymph nodes that your surgeon removes will be examined under a microscope to help decide on any further treatment.

Surgery will also help reduce the chance of the cancer cells spreading to other parts of the body.

Are there alternatives to an axillary node clearance?

Sometimes radiotherapy can be used to treat the lymph nodes in the armpit, instead of removing them.

Your breast cancer team may not recommend further treatment, particularly if only a small number of cancer cells are found in the lymph nodes in your armpit.

What does the operation involve?

The operation is performed under a general anaesthetic and takes about 60 to 90 minutes. It may take a little longer if you have breast surgery at the same time.

A cut is made in your armpit. If you are having an operation on your breast at the same time, it may be possible to use the same cut.

The surgeon will remove some or all of the nodes and surrounding fatty tissue in your armpit.

They will close the cut with stitches, clips or glue.

All your lymph nodes and any breast tissue removed will be examined under a microscope. Your breast cancer team will know the results 1 to 4 weeks later.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• blood clot in your leg
• blood clot in your lung
• chest infection

Specific complications of this operation

• developing a lump under your wound caused by fluid collecting
• developing a lump under your wound caused by blood collecting
• skin necrosis, where some of the skin at the edge of your wound dies leaving a black area
• stiff shoulder
• numbness or continued pain around your armpit or the inner part of your arm
• swelling of your arm, hand or breast
• arm weakness
• infection of the affected arm

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day or the day after.

You should be able to return to normal activities after 2 to 3 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the breast cancer team or your GP for advice.

The breast cancer team will arrange an appointment after the surgery. The lymph nodes and breast tissue that your surgeon removed will have been examined under a microscope. Your breast cancer team will tell you the results and discuss with you any treatment or follow-up you need.

Summary

The lymph nodes in the armpit (axilla) can be affected by breast cancer. Axillary node clearance is a procedure to remove your lymph nodes to help treat the cancer and to prevent it from coming back in your armpit.

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