Axillary dissection

What is an axillary dissection?

An axillary dissection is an operation to remove the lymph nodes in your armpit (axilla). This is done when cancer cells have travelled from the skin cancer and settled in the lymph nodes.

What are lymph nodes?

Lymph nodes are small round structures that trap things like cancer cells, bacteria, or other harmful substances in lymph. Lymph nodes are found mainly in your neck, armpits, and groin. You may have felt swollen lymph nodes when you have had an infection like a

Do I have cancer in my lymph nodes?

Normally when a lump is found, the first step is to take a sample. This is called an ultrasound core biopsy, and it is done in the Radiology (X-ray) department. Once the sample has been taken, it is sent to the laboratory to be looked at under the microscope. You may also have CT scans before your surgery

When will my axillary dissection happen?

An axillary dissection is done once all your test results are available. You will come to hospital early on the morning of your surgery and will stay overnight.

Pre-operative assessment

The pre-operative assessment checks you are ready for surgery. You will answer some questions about your health and may also have tests like blood pressure checks, blood tests, an ECG, and skin swabs.

You may have been asked some of the questions before, but we need to make sure nothing has changed.

You will also receive more information about your surgical pathway (what will happen after surgery). If the assessment reveals a problem that needs treating before surgery, this may delay surgery until the problem is resolved. 

Pre-assessment staff will keep in touch with you and your GP about the best way to sort the issu

What does the surgery involve?

The operation will take about 2-3 hours and is done using general anaesthetic (you will be asleep). All the nodes in that area and some tissues will be removed. You will have a curved scar across your armpit.

What can I expect after the operation?

After your surgery, two drains are placed in your skin to drain lymphatic fluid from the wound. The drains will be connected to bags that will stay there until there is minimal drainage. This may be between 4-10 weeks. You will be shown how to measure and empty the bags before leaving hospital – please see separate leaflet. 

You might feel some pain, especially in the first few days, but it may take a couple of weeks to go away. If necessary, you can take mild painkillers. 

You will see a physiotherapist on the ward who will give you information on exercises to complete after surgery.

What are the possible complications immediately after surgery?

There are potential problems with any operation. Complications are rare with this surgery, but you may have some of the following:

• Numbness of the skin surrounding the groin.
• Bleeding.
• Collection of fluid around the wound.
• Infection.
• Wound break down.
• Swelling of the leg.

If any of these happen, please contact your Skin Cancer Clinical Nurse Specialist who will be able to advise you.

What are the possible long-term complications after surgery?

• A visible scar and hollow area in your armpit.
• Numb skin around the surgery area.
• Swelling in your arm (called lymphoedema)

Lymphoedema

Lymphoedema is swelling in your arm. This happens when your lymphatic system is not working properly and there is a build up of lymph.

Signs of lymphoedema

Lymphoedema can affect you in a variety of ways. If you notice any of these symptoms, speak to your Skin Cancer Nurse or GP.

• Swelling.
• Heaviness of your arm.
• Tightness and stretching of the joints.
• Reduced movement of the joints.
• Thickening and dryness of the skin.
• Discomfort or pins and needles sensat

Can you prevent lymphoedema?

While we don’t know exactly what causes lymphoedema, an infection or injury to the affected limb may slightly increase your risk. Looking after your skin is vital:

• Clean even small cuts and grazes straight away. If you have any sign of infection, see your GP straight away.
• Use a moisturiser daily to keep your skin soft and supple.
• Take care when cutting nails to avoid breaking the skin.
• Avoid hot baths and saunas- this may increase swelling.
• Avoid sunburn by using a SPF30 sunscreen or above and wear loose fitting clothing.
• Avoid cuts when shaving and use an electric razor.

References and further Information

© North Bristol NHS Trust. This edition published March 2025. Review due March 2028. NBT002425