Surgery for Armpit – Called axillary dissection by the oncologists. It involves clearing all the nodal and lymphatic tissue in the armpit. The lymph tissue is present along the large axillary artery and vein and these nodes get involved pretty early in the disease.

Lymphatics are small ducts (Tubes) that run from the breast towards the armpit. These ducts remove fluid in breast tissue and deposit it into blood stream while fresh fluid is formed in the breast tissue. It is a continuous cycle and hence when cancer develops in the breast, the cells slowly enter the lymph ducts and get deposited in the lymph nodes in the armpit.

Nodes are small rounded lumps present along the lymph ducts, like stations whose function is to filter foreign body in the fluid to protect the body. So it is no surprise that cancer cells get stuck here and grow there to form swellings in the armpit.

The lymph nodes in the armpit are multiple and are arranged in three groups. 

These groups are aranged along the major blood vessels that supply the arm called the axillary vessels. The nodes are grouped into three levels numbered from 1 to 3. 

As the disease advances, the disease moves from level 1 to level 3 group of nodes.

The disease by nature moves in a organized manner and the extent of surgery is decided as per nodal involvement.

Surgery in the armpit is done to clear the nodes along the axillary vessels. It is called axillary dissection.

Generally the purpose of this part of breast cancer surgery is done to relieve the patient of possible discomfort of enlarged nodes causing discomfort and pain. Information gained by the study of the tissue removed during this surgery allows us to estimate the intensity of disease spread based on which further treatment like radiation, chemotherapy could be decided.

Axillary Dissection which is done as part of surgery for breast cancer can lead to side effects.  The most common of which is the slow accumulation of fluid in the arm. Starts with swelling of hand and slowly ascends up towards the shoulder. It is called edema which is intially reversible by the elevation of the arm. If persistent and no care is taken can become permanent.

In addition patients express ache or pain in the shoulder.  Sometimes  there could be restriction of shoulder movements if care is not taken through physiotherapy.

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