Axillary Clearance, also known as axillary lymph node dissection, is a surgical procedure performed to remove lymph nodes from the armpit (axilla) region. It is commonly done as part of breast cancer treatment to assess cancer spread, aid in staging and removal of tumorburden to reduce the risk of disease recurrence.

Why is Axillary Clearance Performed?

Axillary clearance is typically performed as part of the surgical treatment for breast cancer. Its primary purpose is to remove and assess lymph nodes from the axilla (armpit) region. This procedure is essential for several reasons:

• Staging: Axillary lymph nodes are a common site for breast cancer metastasis. By examining the lymph nodes, the surgeon determines the extent of cancer spread (staging), which is crucial for treatment planning and prognosis estimation.

• Disease Management: Removing cancer-involved lymph nodes helps in controlling the disease. It reduces the risk of cancer cells spreading to other parts of the body and aids in preventing disease recurrence.

• Treatment Planning: The information obtained from axillary clearance helps tailor adjuvant therapies such as chemotherapy, radiation therapy and targeted therapy to the specific needs of the patient. It allows for a more personalized approach to treatment.

The Procedure:

The procedure involves making an incision in the axilla, identifying and removing lymph nodes and closing the incision site. Axillary clearance is typically performed under general anesthesia and involves the following steps:

• Incision: The surgeon makes an incision in the axillary region, usually following the natural skin creases to minimize scarring.

• Lymph Node Dissection: Using meticulous surgical techniques, the surgeon identifies and carefully removes the lymph nodes from the axilla. The number of lymph nodes removed may vary depending on factors such as the extent of cancer spread and the patient's overall health.

• Hemostasis: Bleeding is controlled and the surgical site is carefully inspected to ensure all lymph nodes have been adequately removed.

• Closure: A drain tube is placed to prevent fluid accumulation. The incision site is closed with sutures or surgical staples, and a sterile dressing is applied.

Benefits of Axillary Clearance:

Axillary clearance offers several benefits for patients undergoing breast cancer treatment:

• Accurate Staging: By examining the lymph nodes, the cancer can be accurately staged, which guides treatment decisions and helps predict prognosis.

• Improved Survival: Removing cancer-involved lymph nodes helps in controlling the spread of the disease, leading to improved long-term survival rates for patients.

• Personalized Treatment: The information obtained from axillary clearance allows for a more personalized approach to treatment, ensuring that patients receive therapies tailored to their specific needs.

• Reduced Risk of Recurrence: By removing potentially cancerous lymph nodes, axillary clearance reduces the risk of cancer recurrence in the axillary region and other parts of the body.

• Psychological Benefits: Knowing that comprehensive treatment, including axillary clearance, has been performed, can provide patients with a sense of reassurance and empowerment as they navigate their cancer journey.

Axillary Clearance plays a crucial role in the management of breast cancer, providing valuable information for staging, treatment planning and prognosis estimation. While it is a significant surgical procedure, the benefits it offers in terms of disease management, personalized treatment and improved outcomes make it an integral part of breast cancer treatment protocols.