Type of Surgery

Information

Doctor Certified

Last updated: 11/24/2009

Diagnosis/Preparation

Operable breast cancer is the primary indication for axillary dissection. Persons receiving this surgery have been diagnosed with breast cancer and are undergoing surgical removal of the breast. Diagnosis of breast cancer typically involves palpation...

of a lump (mass), and other tests such as mammography (special type of x ray used to visualize deep into breast tissues) and biopsy. The specific diagnosis to estimate the extent of axillary (cancerous) involvement can be made by performing a sentinel node biopsy. The sentinel node is the first lymph node that drains fluid from the primary tumor site. If there is no presence of cancerous cells in the sentinel node, the likelihood that higher echelon lymph nodes have cancer is very small. Conversely, if cancerous cells are detected in the sentinel node, then axillary dissection is recommended.

Preparation for axillary dissection is the same as that for modified radical mastectomy. This includes but is not limited to preoperative assessments (special tests and blood analysis), patient education, postoperative care, and follow-up consultations with surgeon and cancer specialist (medical hematologist/oncologist). Psychotherapy and/or community-centered support group meetings may also be beneficial to treatment.



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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.) 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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