Axillary surgery is where your surgeon removes lymph nodes from your armpit. It is usually done at the same time as your breast surgery to remove the cancer.
If breast cancer cells are going to spread, the first place they will go is these lymph nodes.
Lymph nodes are removed either to check whether they contain cancer cells (Sentinel Node Biopsy) or to remove known cancer deposits (Axillary Clearance).
Sentinel Node Biopsy (SNB)
A sentinel node is the first lymph node that cancer cells are most likely to spread to from a cancer. Sometimes, there can be more than one sentinel lymph node.
You will need to have a procedure before your surgery to help identify which nodes are sentinel nodes. This usually involves injection of a radioactive dye on the morning of, or the day before your surgery.
During the operation, your Surgeon will use a gamma probe to locate the sentinel node(s).
An axillary clearance involves removing all lymph nodes in the armpit.
It is usually performed when cancer has been found in the lymph nodes, either with a needle biopsy, or following a sentinel node biopsy.
The surgery is done either at the same time as your breast surgery, or as a subsequent operation. It is done under general anaesthetic and usually requires 2-3 nights in hospital. After an axillary clearance you will have a surgical drain tube in your armpit. This may stay in after you are discharged. If so you will be given instructions and help on how to manage this at home.
When lymph nodes are removed from the armpit (axilla), it can disrupt the flow of fluid draining from the arm. This can result in swelling, or lymphoedema, of the arm.
Lymphoedema is uncommon, but can affect up to 20% of patients who have an axillary clearance, although the symptoms range from very mild to (rarely) severe.
The Breast Cancer Network of Australia website has useful information about lymphoedema, including advice on things you can do to reduce your risk.