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Axillary dissection is a surgical procedure aimed at removing lymph nodes from the axilla, or armpit area, to assess and manage the spread of breast cancer. This procedure is often performed in conjunction with a mastectomy or lumpectomy when there is a concern about cancer metastasis to the lymphatic system. The primary goal of axillary dissection is to determine the presence of cancer cells in the lymph nodes, which is crucial for staging the disease and guiding further treatment options. During the procedure, the surgeon typically makes an incision in the axilla to access the lymphatic tissues and meticulously excises a significant number of lymph nodes, commonly referred to as an axillary lymph node dissection (ALND). This surgical approach is vital in understanding the extent of cancer spread, allowing healthcare providers to tailor adjuvant therapies, such as chemotherapy and radiation, based on the patient's specific pathology report. While this procedure is essential for effective cancer management, it can lead to potential complications, including lymphedema, which is the accumulation of lymphatic fluid causing swelling in the arm. Other risks may include pain, nerve damage, and infection at the surgical site. The decision to perform axillary dissection is often made based on the tumor characteristics, such as size and grade, and the presence of cancer in sentinel lymph nodes, which are the first nodes that cancer would likely spread to from the primary tumor. In some cases, surgeons may opt for a less invasive approach, such as sentinel lymph node biopsy (SLNB), where only a few select lymph nodes are removed and analyzed for cancer cell presence. This technique aims to minimize potential complications while still providing important staging information. The axillary dissection procedure is typically performed under general anesthesia and may require an overnight hospital stay for recovery. Postoperatively, patients may need physical therapy to help regain arm function and manage any side effects related to the surgery. Ongoing follow-up care is crucial for monitoring any long-term effects, especially the risk of lymphedema, which can affect daily activities and quality of life. Overall, axillary dissection plays a pivotal role in the comprehensive treatment of breast cancer, offering insights into lymphatic involvement and enabling personalized treatment strategies that ultimately improve patient outcomes. Through careful evaluation and execution of this surgical technique, healthcare professionals can enhance the accuracy of breast cancer staging while minimizing risks and complications associated with axillary surgery, thereby ensuring that patients receive the most effective therapeutic interventions available.
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