HOW OFTEN IS THIS SURGERY DONE FOR DUCTAL IN SITU CANCER?
It is rarely done for ductal in situ cancer. It is almost always done for invasive breast cancer.
HOW LONG DOES THE OPERATION TAKE?
The operation takes about 2 hours. It is a hospital procedure done with a general anesthetic. You will wake up in the recovery room and depending on how your body reacts to the anesthesia and surgery, you will probably need to stay in the hospital for a day or two.
CAN THIS BE DONE AT THE SAME TIME AS A LUMPECTOMY OR A MASTECTOMY?
An axillary node dissection is often done with a mastectomy. It is sometimes done with a lumpectomy, if a clear diagnosis of cancer has already been established. Otherwise it is done as a second procedure, after a pathological analysis of the tissue removed during your lumpectomy.
DOES THE PROCEDURE HURT?
There is some post-operative pain, and pain medication can be prescribed for you. You will need to stretch the tissue under your arm as you work to regain a full range of motion. This may cause some minor discomfort but it is very important to do these exercises. Pain medication will be provided to you for this purpose if necessary.
HOW MANY NODES ARE REMOVED?
Usually between 10 and 20 lymph nodes are removed. Because the nodes are embedded in fat, the surgeon won't know how many lymph nodes are actually removed until the pathologist examines them. There is also individual variation in the number of nodes imbedded in the removed fat. The number of nodes is not as important as where they are taken from. Every women's nodes are taken from the same "geographic" area in her underarm.
WHAT WILL I LOOK LIKE AFTER THE OPERATION?
Directly after the operation there is usually a small tube in place under your arm (held by a few stitches). The end of the tube has a bulb (about the size of a blood-pressure bulb) which holds the fluid that drains from the surgical area for several days after the operation. It is usually emptied by you or a family member several times a day. When there is consistently less than a tablespoon accumulated, the tube can be easily removed in the doctor's office. There is an thin incision under your arm after the surgery, and perhaps an indentation where the fat has been removed.
A more unusual temporary complication within a week after surgery is a large build-up of fluid under your arm. It is common to have some swelling, but occasionally some women may feel a orange-sized lump under their arm. This is called a seroma. It is a fluid-filled area. If this occurs your surgeon can drain off the fluid.
WILL MY ARM BE MORE SUSCEPTIBLE TO INFECTION?
Your arm and hand are more susceptible to infection since many of the lymph nodes that protect against infection have been removed. It is important to protect that arm and hand forever. You should make sure that blood pressure or blood drawing is always done in your other arm if possible. You should wear gloves when doing any work that could potentially injure your hand, such as dish washing, gardening, or some sports. Most women are asked to check their arm and hand regularly to insure there are no cuts or inflammation. If the tissue has even a minor injury, antibiotics are usually recommended.
IS THERE A RISK OF LONG TERM COMPLICATION?
Yes, you may have temporary or permanent numbness under your arm, and you will always have a higher risk of infection in that arm. There is a 3% chance you may develop lymphedema, a serious side effect that results from excess fluid in your arm.
WILL THE RANGE OF MOTION IN MY ARM BE AFFECTED?
Right after the surgery your shoulder will feel sore and somewhat stiff. It may be difficult to move it in all directions. However, soon after surgery you will be given a series of arm movement exercises to do daily. This helps limber up your arm and shoulder movement. Eventually most women gain 100% motion in the affected arm. It is important to do these exercises daily for many months after the surgery, to establish and maintain full range of motion. In some cases, exercises are recommended for the rest of your life.
HOW LONG DOES IT TAKE TO RECOVER FROM THIS SURGERY?
This depends on each woman's individual circumstances, ask your health care provider about your specific case.