What is axillary lymph node dissection?

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Axillary lymph node dissection: Overview

Lymph nodes move and filter fluids between body tissues and the bloodstream. Because of this, cancer cells often spread to the lymph nodes. An axillary lymph node dissection is surgery to remove lymph nodes from under your arm.

This surgery is usually done during your lumpectomy or mastectomy. During this surgery, your doctor will remove lymph nodes that have cancer and those that cancer could easily spread to. This surgery reduces the chance that the cancer could come back. It also helps your doctor plan further treatment for you.

After the surgery, you may go home the same day. Or you may need to spend the night at the hospital. You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any other treatment you may need.

After your lymph nodes are removed, you will be at greater risk for swelling in your arm. This is called lymphedema. You will have to take good care of your affected arm. Your doctor or physical therapist will tell you what to look for. They will also teach you how to take care of your arm.

This surgery may be done at the same time as other breast surgeries. If this is the case, how you prepare may be different.

Lymph Node Dissection: Self-Care at Home

How do you prepare for axillary lymph node dissection?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After axillary lymph node dissection: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You cannot pass stools or gas.
  • You are sick to your stomach or cannot drink fluids.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness or swelling in your leg.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have any problems.
  • You have new or worse swelling or pain in your arm.

After axillary lymph node dissection: Overview

Right after the surgery you will probably feel weak, and your shoulder area will feel sore and stiff for a few days. It may be hard to move your arm and shoulder in all directions. Your doctor or physical therapist will teach you some arm exercises. You now have a higher chance of swelling in the affected arm. This is called lymphedema. From now on, you will have to be careful when using your arm.

You will have a scar under your arm that will fade over time. You may also notice a hollow area in your armpit. It may also feel like you have a lump in your armpit. You may lose some feeling under your arm, or the arm may have a tingling or burning feeling. The loss of feeling may last only a little while, or it may last the rest of your life.

You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any further treatment. If cancer was found in the lymph nodes, you will probably need more treatment.

An axillary node dissection may be done at the same time as other breast cancer surgeries. If this is the case, your recovery may be different.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counselors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org for more information.

What happens on the day of your axillary lymph node dissection?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take 1 to 2 hours.
  • You may have a drain in your underarm.

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