Axillary Lymph Node Dissection: Before Your Surgery

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What is an axillary lymph node dissection?

An axillary lymph node dissection is done to see if breast cancer has spread to any of the lymph nodes that drain the breast area. Lymph nodes move and filter fluids and other materials, such as cancer cells, between body tissues and the bloodstream. Because of this, cancer is often found in lymph nodes. Many of the lymph nodes in the breast area are in the armpit. Your doctor will remove a number of lymph nodes and have them tested for cancer. If cancer is found, you may need more tests and treatment.

After the surgery, you may go home the same day. Or you may need to spend the night at the hospital. You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any other treatment you may need.

After your lymph nodes are removed, you will be at greater risk for swelling in your arm. This is called lymphedema. You will have to take good care of your affected arm. Wear loose sleeves and bracelets. Don't carry heavy things with that arm. Your doctor or physiotherapist can teach you arm exercises. Doing these can help you move your arm as you always have.

This surgery may be done at the same time as other breast surgeries. If this is the case, how you prepare may be different.

You may feel sad or depressed after a dissection and have concerns about your body image and sexuality. This is common. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take 1 to 2 hours.
  • You may have a drain in your underarm.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to http://www.healthwise.net/ed

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