Axillary Clearance

Removal of all of the lymph nodes under the arm is performed if there is evidence of malignant cells in a lymph gland, either demonstrated on a prior sentinel lymph node biopsy or on needle biopsy of an abnormal lymph node pre-operatively.

The majority of lymph glands under the arm draining from the breast region are removed. This number is variable but on average, between 10-30 lymph nodes would be removed. This may result in some numbness of the axilla and inner aspect of the upper arm. Physiotherapy is required to return range of movement in the shoulder back to normal. A small number of cases may develop swelling of the arm and/or forearm (lymphoedema). This risk can be minimised with regular physiotherapy and avoidance of infections in that arm. A drain is usually placed which would remain for three to seven days, depending on the amount of drainage of fluid (seroma) from the surgical site. Even after removal of the drain, fluid may collect at the surgical site in the ensuing weeks, resulting in some swelling requiring painless manual drainage (performed at our office) with a needle and syringe (aspiration), .

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