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Axillary Lymph Node Dissection

What is a lymph node dissection?

 

Lymph node dissection is a surgery to remove lymph nodes. This can be done for axillary lymph nodes, which are under and around the armpit. It may be recommended for you if cancer is suspected or found in the lymph nodes. If you are having other surgeries for cancer treatment, lymph node dissection may be done at the same time or it may be the only surgery you have that day.

 

Our bodies have a network of nodes and vessels that carry a watery clear fluid called lymph. This fluid flows throughout our bodies, similar to the way blood vessels carry blood to all parts of the body. The lymph fluid contains white blood cells, which help us fight infections. Cancer cells can travel to the lymph system. Because the lymph system runs throughout the body, these cancer cells may spread to other areas.

 

What are the risks associated with lymph node dissection?

 

Removal of lymph nodes can change the way the lymph fluid flows in the side of the body where they were removed. If the remaining lymph vessels do not allow fluid to flow freely, the fluid builds up and causes swelling or lymphedema.

 

Swelling of the arm may be slight, making the skin on the affected area feel tight, or it may be severe, causing your entire hand/arm to be very swollen. The swelling may appear months to years after surgery. If you receive other types of treatments (such as radiation), you are more likely to develop swelling. You may not notice swelling on a day- to-day basis, but this does vary. It is difficult to predict if someone will develop lymphedema. The reported risk ranges from 2 percent to 40 percent.

 

Right after surgery, it is normal to have some swelling in the area where the lymph nodes were removed. Most often, this swelling is temporary. If you have swelling, your doctor will watch it, and you may have a visit with an occupational or physical therapist to further examine the swelling.

 

What can I do to reduce the risk of getting lymphedema?

 

The chance of developing lymphedema after a lymph node surgery varies. It is very hard to do research studies that evaluate ways to prevent lymphedema. However, there are a number of simple steps that may help lower your risk of developing lymphedema or keep it stable. Mostly, these are common sense, but you should use your own judgment.

 

Skin Care to Prevent Infection and Avoid Trauma

  • Keep the area clean and dry. Clean, protect and watch minor cuts on or near the affected area. Use an over-the-counter antibacterial cream on any openings after they are cleaned. Cover them with a bandage, if needed. Avoid insect bites, animal scratches, cuts or skin punctures. Use insect repellent when outdoors to avoid bug bites. If you get stung by a bee, clean and elevate your arm or leg and apply ice.
  • Use lotion to prevent cracked skin where germs may enter.
  • Be careful when cutting your nails. Avoid cutting cuticles.
  • If possible, avoid punctures in the affected arm, such as needles for IVs or drawing blood. Do not have your blood pressure taken or blood drawn from the affected arm.
  • Avoid tight jewelry and clothing.
  • Wear gloves when you are working in the garden, using strong cleaning products or cleaning up after pets.
  • Call your doctor if you notice swelling, pain, redness, increased warmth or fever.

Activity

  • Recent data suggests that regular exercise may help patients with lymphedema. Gradually build up your strength and the amount of time of any activity that uses the affected arm.
  • Maintain your weight at an acceptable level; some studies have shown that obesity or rapid increases in weight can be a risk factor for lymphedema. Avoid shoulder bags on the affected arm.

Other Recommendations

  • Some people are sensitive to extremes in temperature. Monitor your affected arm when using hot tubs or saunas. If swelling increases, avoid these activities.