Your doctor suggests that you remove lymph nodes in the armpit. This procedure is called axillary dissection.
Principles and objectives
This procedure involves removing the lymph nodes associated to the breast, located in the armpit, which can be invaded by cancer cells.
Axillary dissection has two main objectives:
Place of intervention in general treatment
This operation is part of a treatment program developed with the various oncologist doctors who will participate in your care. This will be explained to you by your surgeon before the operation and especially after it, once in possession of the tests run on the removed tissues.
How do you prepare?
Axillary dissection is performed under general anesthesia.
The anesthesiologist, responsible for this part of the procedure, will answer all questions relating to his specialty during the obligatory preoperative consultation.
It is very important to specify to the surgeon and the anesthesiologist the treatments that you take regularly, even for not a long time and in particular aspirin, anticoagulants etc.
If you have ever had allergic reactions, you should report it.
Finally, upon admission, you must bring your last mammograms, breast ultrasound and MRI.
Your will be accepted to the hospital in the morning of the operation and you will need not to eat, drink or smoke from midnight until the time of the operation. You will be prepared for the operation by a nurse.
Before arriving in the OR, the healthcare team prepares the armpit to be operated on and you take a shower with an antiseptic product. You will have had your hair removed or shaved 3-5 days before the operation.
A premedication, which aims to sedate you, will be given to you before your arrival into the operating room.
The duration of the intervention is usually less than an hour.
This operation is often performed at the same time as lumpectomy or mastectomy.
Only 10 to 15 axillary nodes are removed. The surgeon removes the area where the lymph nodes associated to the breast are located.
We can also, depending on the nature of the tumor and its size, offer you a operation limited to the sentinel node, a decision that will be made in a team with the oncologist or oncologist.
The scar is not very visible, it is located in the armpit. The operation can also be done in the extension of the scar left of previous of the mastectomy or the lumpectomy or as a separate scar.
A drainage system, called a redon drain, is sometimes put in place to prevent the accumulation of lymph and / or blood in the operated area. It will be withdrawn as soon as the volume collected is reaching certain amount. Your return home with this drain can only be considered with the agreement of your surgeon. If during surgery your surgeon is faced with an unforeseen situation requiring additional acts, he can then perform a procedure that he deems necessary.
After the intervention
You will stay in the recovery room before returning to your room.
You can resume your normal diet usually the evening or the day after the intervention.
The discharge is planned the same day, in the absence of drainage, according to the healing and your general condition, or the next day.
The bandage is changed before you go out and the scar is usually left in the open air. Prescriptions will be given to you and the appointment with your surgeon will be fixed for the postoperative visit during which we will check your scar then we will give you the results of the tests on the removed tissues.
The sutures are absorbable and the scar does not require any special care, except a daily careful cleaning with soap and water, followed by drying. You can take showers the day after the procedure. It is recommended to wait a month before immersing the scar in a bath. No pool either.
Wearing a bra without underwire is recommended in the days following the operation.
Except in special cases, an anticoagulant treatment is prescribed after the operation to reduce the risk of phlebitis or embolism.
In case of fever, scar disunity, severe discharge, pain, especially in the calves or any other abnormality, you must inform your doctor and / or call the Institut Curie.
Axillary lymph node dissection is a common intervention, the procedure for which is simple in the vast majority of cases.
After the intervention, the pain is variable but most often moderate. Treated preventively and adapted to your case, pain is the subject of our full attention, especially during the first 24 hours after operation.
Sometimes a pocket of fluid called a "lymphocele" can form under the scar. This liquid is evacuated by a simple puncture.
When you leave, you will be given a telephone number to call if necessary.
When skin healing is difficult, especially after radiotherapy, it may require special care. Hematomas and infections are still possible after surgery but rare. In most cases, they can be treated locally. Sometimes a new intervention is necessary to drain or clean the area.
Any medical act, investigation, exploration, intervention on the human body, even conducted under the conditions of competence and safety in accordance with current data from science and regulations in force, conceals a risk of complication which can be life-threatening.
In the exceptional case of a hemorrhage, a blood transfusion or plasma transfusion may be necessary.
In case of suspected risks, blood thinners limit the chances of pulmonary embolism.
After a few days, the spontaneous pain is minimal and only pain on palpation of the area persists.
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