The axillary lymph nodes are located under the arm. Axillary node dissection is performed to determine if cancer has spread beyond the breast. Cancer cells found in the lymph nodes suggest that it may have spread to other parts of the body and the patient may need more aggressive treatment. The results of this test help the patient and physician plan the best course of therapy.
An axillary node dissection may be done at the same time as a lumpectomy or a mastectomy. It may be scheduled following a positive biopsy.
Axillary node dissection is performed under general anesthesia (agent that renders the patient unconscious) at a hospital. The surgeon makes an incision under the arm and removes a pad of fat in which 10 to 20 lymph nodes are embedded. The incision is sutured and a drain may be put in to remove excess fluid. The procedure takes between 1 and 2 hours.
Preoperative Procedures
A few days before surgery, tests are usually performed to assess the patient's health. Preoperative tests ordered vary according to the patient's age and health, but generally include a blood test, a chest x-ray, and possibly an electrocardiogram (EKG). If these tests have been performed recently, such as for breast biopsy, they do not need to be repeated.
If the patient is taking medication that "thins" the blood , including aspirin, they should speak to their physician about it as soon as the decision to do the biopsy has been made. Patients usually stop taking blood thinners several days prior to a scheduled operation to avoid excessive bleeding during the procedure.
Because axillary dissections are usually performed under general anesthesia, the patient must refrain from eating or drinking at least 8 hours prior to surgery. This may include oral medications, and this must be discussed with the physician. On admission to the hospital, the patient must sign an informed consent form acknowledging that they understand the procedure and its risks, and that they will be receiving anesthesia and certain medications.
The anesthesiologist (the doctor who administers the anesthesia) performs a brief physical examination and takes the patient's medical history. The anesthesiologist asks about medications that are currently being taken, about a history of allergies, and about previous adverse reactions to anesthesia. This information is essential to assess possible conditions or problems that may influence the choice of anesthesia and to take any special precautions if necessary.
An intravenous line (IV) will be started to administer fluids and medication during the procedure. This may be done in the patient's room or in the preoperative holding area. It is necessary to stay in bed from this point on, except to use the bathroom.
Sedation may be given in the holding area or in the hospital room, and the anesthesia is administered in the operating room.
Postoperative Care Immediately foll...
Click here to read the rest of the article from surgerychannel
