Type of Surgery
Information
Last updated: 11/24/2009
Lymph nodes (or lymph glands) are filtering centers for the lymphatic system (a system of vessels that collects fluids from cells for filtration and reentry into the blood). Additionally, there is a complex arrangement of muscles, tissues, nerves and...
blood vessels. Axillary dissection is surgically explained in terms of three levels. Level I axillary dissection is also called lower axillary dissection because it is the removal of all tissue below the axillary vein and extending to the side where the axillary vein crosses the tendon of a muscle called the latissimus dorsi. Level II dissection is continuous—it includes the removal of level tissues and further extensive removal of cancerous tissues. Level II dissection removes diseased tissues deeper in the middle (medial) area of another muscle called the pectoralis minor. Level III dissection is the most aggressive breast cancer axillary surgery, and it entails the removal of all nodal tissue (tissues related to the lymphatic system) from the axilla.
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The lymphatic system keeps our tissues from retaining fluid and houses many of the key components of the immune system, like lymph nodes. Learn how this underappreciated body system is organized and how it functions.
To determine the advancement of breast cancer, lymph nodes in the armpit are removed. An incision is made (A), and lymph nodes are removed and tested (B), leaving a small scar (C). (Illustration by GGS Inc.)
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Other Information
Definition
Axillary dissection is a surgical procedure that incises (opens) the armpit (axilla or axillary) to identify, examine, or remove lymph nodes (small glands, part of the lymphatic system, which filters cellular fluids).
Purpose
Axillary dissection is utilized to stage breast cancer in order to determine the necessity of further treatment based on cancer cell spread. Additionally, axillary dissection includes removal and pathological examination of axillary lymph nodes for persons having operable breast cancer. The anatomy of the axilla is complex and composed of several critical nerves, arteries, and muscles. Because of this complex anatomy and connection with the breast, the axilla is a common route for possible metastatic (cancer cell spread to distant areas within the body) involvement from breast cancer. The absence or presence of cancer cells in axillary lymph nodes is the most power prognostic (outcome) indicator for breast cancer. Axillary dissection is an accurate procedure for axillary node assessment (removal and pathological examination). Clinical examination of the breast (more specifically palpation, or feeling the affected area for lumps) for the axillary region is inaccurate and unreliable. The only method to identify whether or not a lymph node has cancer cells, is to surgically remove the node and perform examination with a microscope to detect abnormal cancer cells.
From http://www.healthline.com/galecontent/axillary-dissection
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