BREAST CANCER TREATMENT
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Axillary Lymph Node Dissection
Removal of axillary lymph nodes (axillary lymph node dissection) has 3 purposes:
- Accurate staging of the disease
- Guiding concomitant therapies
- Ensuring local tumor control in patients with lymph node involvement
The presence or absence of axillary lymph node involvement is the most important parameter for the prognosis of breast cancer (how much it threatens the patient’s life).
While removal of the lymph nodes related to the breast fulfills the above-mentioned objectives, there is a risk of side effects such as swelling in the arm, which is rare. Some precautions are taken to prevent these risks, such as protecting the patient’s hand and arm from injury.
Recent studies have shown that 8-10 lymph nodes need to be removed for accurate sampling of the armpit.
Statistics show that approximately 60% of all breast cancers and 75% of early stage breast cancers do not involve the axilla lymph nodes at the time of diagnosis.
Axillary Lymph Node Dissection – Points to Consider After Removal of Axillary Lymph Nodes
- In patients undergoing axillary dissection, it is very important to protect the arm from trauma and infection. As lymph flow may be affected, swelling in the arm (lymphedema) may develop.
- The risk of lymphedema is closely related to how large the axillary lymph nodes are removed. This rate is considerably lower after sentinel lymph node sampling.
- There may be temporary, rarely permanent limitation of movement in the arm and shoulder. Arm exercises are started after the drains are removed. It is especially useful to start some exercises that increase the movements of the shoulder joint.
- After the drains are removed, lymph fluid may collect in the armpit and under the skin of the breast (seroma). There is no need to intervene as long as it does not reach dimensions that disturb the patient. Otherwise, it can be drained with a syringe.