Axillary lymph node dissection

Lymph nodes are small glands found in various locations across the body which form part of the lymphatic system. The lymphatic system is a connected web of tubes found throughout the body which carries a fluid (lymph). Lymph fluid is used to transport a number of waste products and damaged cells away from areas of the body. The lymph nodes are then used to process this fluid and filter the waste products.

Our lymph nodes also support our lymphatic and immune system by producing large number of white blood cells known as lymphocytes.

One of the largest collection of lymph nodes in the body is under the armpit (axilla). These axillary nodes drain fluid from the upper limb, breast and other nearby tissues. An axillary lymph node dissection is an operation to remove these lymph nodes and is normally performed to prevent the spread of cancer via the lymph nodes or to remove potentially cancerous cells from the lymph nodes themselves.

The operation is performed by making incisions in the armpit and firstly protecting the major arteries, veins and nerves which lie in this area. Once these have been adequately protected the lymph nodes will be removed. Two plastic drains will be placed where the lymph nodes were removed from to clear lymph fluid still passing through this channel.

The most common side effect of an axillary lymph node dissection is persistent swelling in the arm on the side of the dissection called lymphedema. In some cases the lymphedema my not improve in the months following surgery to give permanent, significant swelling in the arm.

Other risks with an axillary lymph node dissection can include:

  • General anaesthetic risks (commonly nausea and fatigue)
  • Wound infection
  • Damage to the nerves in the axilla
  • Stiffness and pain to the shoulder joint

Immediately after an axillary lymph node dissection you will be closely monitored by your surgical team and our expert nursing staff to ensure there are no complications. A normal stay in hospital is between one and two days. Antibiotics may be prescribed to reduce the chances of developing an infection.

Pain in the operated axilla is normal and if there is significant shoulder stiffness then physiotherapy can be arranged to help regain the lost movement. Pain and movement often normalises after a few weeks. To reduce the chance of lymphedema developing it is best to elevate the arm when resting. Under normal circumstances patients are able to get back to activities of daily living a few weeks after surgery.

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