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Axillary surgery is a key aspect of breast cancer treatment, especially when the cancer has spread to the lymph nodes in the armpit. It helps oncologists understand the stage of cancer and plan further treatments like chemotherapy or radiation therapy. By removing affected lymph nodes, it can lower the risk of cancer recurrence. The extent of lymph node involvement determines the type of axillary surgery needed, which can range from sentinel lymph node biopsy to axillary lymph node dissection. Here are three main procedures.

1. Sentinel lymph node biopsy
  • This procedure identifies and removes the first lymph nodes where cancer is likely to spread from the breast. It’s minimally invasive and helps determine if cancer has metastasized to the lymph nodes, guiding treatment decisions.
2. Targeted dissection
  • Unlike more extensive procedures, targeted dissection focuses on removing only the lymph nodes visibly affected by cancer. This approach minimizes complications and preserves healthy tissue.
3. Axillary clearance
  • In this procedure, at least 10 lymph nodes in the armpit region are removed to provide a comprehensive assessment of cancer spread. However, it carries a higher risk of side effects.

While these procedures are essential for managing cancer, they can sometimes lead to side effects like lymphedema or nerve damage. I carefully select the most suitable approach, based on tumour biology, nodal involvement or preoperative chemotherapy and patient’s response. Each procedure has its benefits and potential side effects, which I thoroughly discuss with my patients to ensure informed decision-making. My goal is to achieve optimal cancer control while minimizing any adverse effects, ultimately prioritizing the well-being and quality of life of each individual under my care.