The supraclavicular fossa is an anatomical region located just above the collar bone in the lower neck, where lymphatic fluid drainage from the breast and adjacent areas converges. In cases where cancer cells have spread to nearby lymph nodes, the supraclavicular fossa may harbour metastatic deposits. Supraclavicular fossa clearance involves the surgical removal of these affected lymph nodes to prevent further cancer spread and optimize treatment outcomes.

Why is Supraclavicular Fossa Clearance Necessary?

• Disease Control: Breast cancer cells have the potential to spread to regional lymph nodes, including those in the supraclavicular fossa. Removing these involved lymph nodes helps control the spread of cancer and reduces the risk of relapse.

• Improved Survival: Studies have shown that thorough lymph node clearance, including the supraclavicular region, correlates with improved overall survival rates in breast cancer patients.

Procedure of Supraclavicular Fossa Clearance:

• Preoperative Evaluation: Prior to surgery, patients undergo thorough clinical and radiological assessments to determine the extent of lymph node involvement and plan the surgical approach.

• Anesthesia: Supraclavicular fossa clearance is typically performed under general anesthesia to ensure patient comfort and safety during the procedure.

• Incision and Access: A carefully planned incision is made in the lower neck above the collar bone to access the affected lymph nodes while minimizing scar visibility.

• Lymph Node Dissection: The surgeon meticulously identifies and removes the affected lymph nodes, taking care to preserve surrounding structures such as nerves and blood vessels.

• Hemostasis and Closure: Bleeding is controlled, and the surgical site is thoroughly irrigated before closure. Depending on the extent of surgery, a drainage tube may be placed to prevent fluid accumulation.

• Postoperative Care: Patients are closely monitored postoperatively and appropriate pain management and wound care measures are provided.

Benefits of Supraclavicular Fossa Clearance:

• Enhanced Disease Control: By eliminating cancerous lymph nodes, supraclavicular fossa clearance reduces the risk of cancer recurrence and progression.

• Accurate Staging: Clearing the supraclavicular nodes provides critical staging information, enabling tailored treatment strategies and prognostic assessment.

• Improved Survival Outcomes: Studies have demonstrated the association between thorough lymph node clearance, including the supraclavicular region, and improved long-term survival in breast cancer patients.

• Symptom Relief: In cases where supraclavicular lymph node enlargement causes discomfort or functional impairment, clearance surgery can alleviate symptoms and improve quality of life.

Supraclavicular fossa clearance plays a crucial role in the comprehensive management of breast cancer, particularly in cases involving lymphatic spread to the supraclavicular region. By meticulously removing affected lymph nodes, this surgical procedure helps control disease progression, refine staging accuracy and improve long-term survival outcomes for breast cancer patients.