Axillary Node Clearance

Axillary node clearance, also known as axillary lymph node dissection, is a surgical procedure that involves the removal of lymph nodes from the axilla (armpit) to treat or prevent the spread of cancer, typically breast cancer.

Indications

• Breast cancer: Axillary node clearance is often performed in conjunction with mastectomy or lumpectomy to remove cancerous cells that may have spread to the lymph nodes.
• Lymphoma: The procedure may be used to treat certain types of lymphoma, such as Hodgkin's disease or non-Hodgkin's lymphoma.
• Melanoma: Axillary node clearance may be performed to treat melanoma that has spread to the lymph nodes in the axilla.

Procedure

The procedure typically involves:

• An incision in the axilla, usually around 5-7 cm long.
• Dissection and removal of the lymph nodes, which are then sent to a laboratory for examination.
• Closure of the incision with sutures or staples.

Types of Axillary Node Clearance

• Level I: Removal of lymph nodes from the lower level of the axilla, which includes the lateral, anterior, and posterior groups.
• Level II: Removal of lymph nodes from the middle level of the axilla, which includes the central and interpectoral groups.
• Level III: Removal of lymph nodes from the upper level of the axilla, which includes the apical group.

Risks and Complications

• Bleeding or hematoma.
• Infection.
• Nerve damage, resulting in numbness, tingling, or weakness in the arm or hand.
• Lymphedema (swelling of the arm or hand) due to disruption of lymphatic drainage.
• Seroma (fluid accumulation at the surgical site).

Recovery and Rehabilitation

After axillary node clearance, patients typically require:

• Pain management with medication.
• Wound care and dressing changes.
• Physical therapy to maintain range of motion and strength in the affected arm.
• Lymphedema prevention and management techniques, such as compression garments and exercises.

Follow-up Care

Regular follow-up appointments with a healthcare provider are essential to:

• Monitor for signs of infection or complications.
• Assess lymph node status and adjust treatment plans as needed.
• Provide ongoing support and guidance for managing side effects and promoting recovery.