An axillary lymph node clearance is also known as a ‘lymph node dissection’ or a ‘lymphadenectomy’. It involves removal of all the lymph nodes and possible tumour containing tissue from the armpit.

The lymphatic system transports a substance called ‘lymph’ around the body. Lymph is produced when liquid leaves the blood vessels and enters the surrounding tissues to help provide them with nutrients and oxygen. The lymph fluid is then collected in lymphatic vessels that run up the limbs and chest, and re-enters the bloodstream near the heart. Specialised clusters of tissue called ‘lymph nodes’ (found in the groin, armpit, abdomen, chest and neck) filter lymph travelling through the lymphatic vessels, removing bacteria and cancer cells and preventing these from spreading elsewhere in the body.

Some cancers, such as melanoma and squamous cell carcinoma, can spread to other parts of the body by the lymphatic system. When cancer cells are filtered, they can get caught in the lymph nodes and can grow there. For example, cancer cells from a skin cancer on the hand can be transported in the lymph via lymphatic vessels to the axilla where they can get caught in lymph nodes and begin to grow.

If the cancer has spread to your lymph nodes, lymph node clearance is usually recommended. A lymph node clearance is a major operation that aims to stop the cancer from progressing in this region.

The Benefits of Surgery

Surgery to remove the lymph nodes in the axilla will remove all the lymph nodes in the area and help to control the spread of the cancer and hopefully, reduce the chance of spread to other parts of the body.

The operation involves making an incision in the armpit. Major nerves, arteries, veins and other structures are protected, and then all of the surrounding tissue (including the lymph nodes) is removed. The operation will disrupt the lymph drainage channels, causing the lymph liquid to collect in the space where the tissue has been removed. For this reason, two plastic tubes (drains) will be inserted to drain the liquid out of the body and prevent it from causing problems.

The tissue that has been removed is sent to the pathologist for examination under a microscope. This is to assess how far the cancer has spread. The results of this assessment usually takes a few weeks and will be discussed with you when the results are available.