Axillary Node Dissection

What is an axillary node dissection?

An axillary node dissection is surgical removal of the lymph nodes from your armpit. The most common reason for this procedure is to manage cancer that has spread from the breast or from melanoma.

There are a variable amount of lymph nodes present which lie in a package of fat, the whole node bearing, fatty tissue is removed.

How is the surgery performed?

You will have a general anaesthetic. The incision will vary depending on whether your operation is combined with a breast operation or being done as a separate procedure.  The most common site for the incision is just under the hair-bearing area of your armpit. The fatty lymph node bearing tissue is dissected free from surrounding structures. There are a number of nerves and vessels in the armpit which are important to identify during the operation. A drain will be placed. Your incision will be closed with dissolvable sutures. A waterproof dressing will be placed.

What are the risks of axillary node dissection?

Bleeding. Infection. Recurrence. Lymphoedema 30%. Division of the intercostal brachial nerve causing numbness/tingling in the inner arm (common).  Injury to long thoracic or thoracodorsal nerve (rare).  

Before the operation

You will be admitted on the day of surgery. You are not able to eat or drink for 6 hours before the procedure.

After the operation

You will likely stay one night on the ward. Your drain stays until there is less than 30ml/day coming out.  The District Nurse will monitor this and remove it. The dressing can stay on for 1 week and then be changed.  It is waterproof so you can shower with it and pat it dry. You will be seen in the rooms in 3 weeks once your results are available for a follow-up appointment. You may require other treatments for cancer including radiotherapy, chemotherapy and hormone therapy. This will be known when you return for your follow up appointment and any referrals will be made to other specialties as needed.