What Is an Axillary Resection?

S. Berger

Lymph nodes in the armpit, or axilla, can sometimes reveal the presence of disease states such as breast cancer. An axillary resection is the process of removing these lymph nodes to look for cancer signs. Between five and 30 lymph nodes are typically removed in this type of resection, and the spread of cancer may be determined from how many nodes have been affected.

Giving a patient general anesthesia is part of the preparation for an axillary resection.
Giving a patient general anesthesia is part of the preparation for an axillary resection.

Nodes are divided into three levels, depending on their location and proximity to the breast. Most of the time, an axillary resection only investigates Level 1 and Level 2 nodes. Level 1 lymph nodes are found next to the pectoralis major, a large chest muscle. Slightly higher are the Level 2 lymph nodes. The presence of cancer in Level 2 nodes would indicate a greater spread of the disease.

An axillary resection is the process of removing lymph nodes to look for signs of cancer.
An axillary resection is the process of removing lymph nodes to look for signs of cancer.

This procedure may be performed not only as a diagnostic measure, but as a treatment as well. At times used in the treatment of breast cancer, the purpose of an axillary resection may be to prevent cancerous lymph nodes from facilitating the spread of cancer. When it is performed, it is usually done at the same time as a mastectomy or lumpectomy.

Patients may experience arm pain following an axillary resection.
Patients may experience arm pain following an axillary resection.

Preparing for an axillary resection often involves general anesthesia, without the addition of any chemicals that would block nerve transmission to muscles. These chemicals are not used because they could prevent the surgeon from identifying whether important nerves are being damaged as part of the surgical process. The surgeon must also identify the positions of the axillary artery and axillary vein to avoid cutting these blood vessels. Blood vessel location can also be used to orient the surgery, and to ensure that incisions are being made close to the lymph nodes.

Blood vessel location can be used to orient the surgery, and to ensure that incisions are being made close to the lymph nodes.
Blood vessel location can be used to orient the surgery, and to ensure that incisions are being made close to the lymph nodes.

After an axillary resection, some time for healing should be expected, along with a significant chance of complications. About four-fifths of people that undergo this procedure have had some form of arm problem within several months following surgery. Problems often include swelling in the area, arm weakness, stiff arms, a limited range of motion, and residual pain and numbness.

Approximately one-fifth of the patients that have had this operation experience significant arm pain that persists for a long time following surgery. After one year, about one-quarter of the patients continued to have swelling, and some two-fifths had problems moving the arm at the shoulder. The greater the extent of the surgery, in general, the more severe the complications tend to be.

An injured or dislocated shoulder is a common cause of axillary nerve dysfunction.
An injured or dislocated shoulder is a common cause of axillary nerve dysfunction.

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