Axillary Node Clearance

Transcription

1 Axillary Node Clearance Important information for patients We care because you matter

2 Axillary Node Clearance The operation you are due to have is an axillary node clearance. This booklet has been written with the aim of answering some of the questions you may have regarding your operation and after care. It includes general advice, which may or may not be appropriate to you. If you still have unanswered questions, need more specific information, or would like to see photographs of patients who have had similar surgery, please don t hesitate to ask your Macmillan Breast Care Nurse who is your key worker. Members of the breast care team have compiled this booklet. The operation Axillary Node Clearance is an operation to remove the lymph nodes under the armpit. Breast cancer sometimes spreads to the lymph nodes, and if this has happened it is important to remove the lymph nodes to remove the cancer in your armpit. The results of the operation also give us very important information which helps us to plan further treatment. This operation is sometimes combined with breast surgery, or may be done as a separate procedure. You will be admitted on the morning of your operation. The operation will be done under a general anaesthetic. One of the doctors will come and mark the side to be operated on with a special skin marking pen. They will answer any queries you have and will also ask you to sign your consent form. The nurses will then help you get ready for your operation. During the operation fat is taken from the armpit and this contains the lymph nodes. The cut is closed with a dissolvable stitch. 2

3 You will also have a drain which is a small plastic tube that leads from the inside of the wound into a small plastic suction bottle that takes away the excess fluid that collects there. This is called serum. This will be removed when the amount of fluid produced decreases. It is alright to go home with your drain in place. You will usually be able to go home within 24 hours. General information Seroma The most common thing to happen is that the fluid continues to collect under the wound after the drains have been removed. It is uncomfortable but it is not dangerous. If you have a build up of fluid please contact your Macmillan Breast Care Nurse who can remove this quite easily in clinic using a needle and syringe. Numbness or pain Your armpit can sometimes be quite uncomfortable following surgery. Shooting pains, burning sensations, and other sensations may occur. This is due to the irritation of the nerves and will settle down. If you are concerned, please contact your Macmillan Breast Care Nurse. You will be given regular pain relief whilst you are on the ward and you will be given pain relief tablets to take home with you. Frozen shoulder This is a painful condition and it is very difficult to move your arm. You should take your painkillers regularly and do the exercises shown to you by the physiotherapist to avoid this happening to you. If you have any concerns about your arm movements you should contact your Macmillan Breast Care Nurse. 3

4 Infection Infection is uncommon, but can happen after any operation. If your wound becomes red and inflamed, becomes increasingly painful, or you have a temperature you should see your GP that day. If this happens during out of hours, please contact the ward. Please also inform your Macmillan Breast Care Nurse. Lymphoedema Lymphoedema is swelling of the arm. Lymph is a colourless liquid, which forms in the tissues in the body. Under normal circumstances, it drains back into the blood stream through the lymphatic system, a network of lymph vessels and lymph nodes. If the lymph nodes are damaged, by surgery or radiation to that area, you may be at risk of developing lymphoedema. It is possible that this could occur months or even years after your initial treatment. If you notice any swelling or heaviness of your arm or swelling of the area around your breast, please contact your Macmillan Breast Care Nurse who can offer the appropriate advice. General advice Wash and pat dry the affected arm. Apply cream daily to your arm. Any non-perfumed cream or lotion that suits your skin is acceptable for example E45. Apply the cream starting at the top of your arm in an upward, gentle stroking movement gradually working your way down the arm to the fingertips. Lastly, stroke the arm from the shoulder to the fingertips in one movement, which will allow the hairs on your arm to return to their natural position. Be more cautious and try to prevent cuts, scratches and grazes to the arm. Apply antiseptic lotions to any cuts or scratches. Use gloves for heavy household jobs and gardening. 4

5 Don t get sunburnt. You are advised to use a high factor sun cream or to wear long sleeves to cover up. Take care when cutting your nails. Avoid blood samples, injections and blood pressures on that arm. Use insect repellent when outside or when travelling to hot climates. If you feel you have an infection in your arm please see you GP as antibiotics may be required. Use a depilatory cream to remove hair from the armpit, but always do a patch test first to ensure you are not allergic to the cream. Electric razors can also be used, but wet shaving is not advised as potential cuts can introduce infection. Don t overdo heavy arm exercises. Always increase intensity and volume of arm exercises slowly and gradually. Swimming is an excellent activity as water supports your arm and will help promote drainage of fluid. Yoga and Tai Chi are forms of gentle controlled exercise, which may help. 5

6 Useful organisation for support and information The Lymphoedema Service St Luke s Hospice Grosvenor House Queensway Winsford CW7 4AW Tel: Macmillan Information and Support Service Leighton Hospital Direct Line: macmillaninfo-support@mcht.nhs.uk Breast Cancer Care Helpline: Freephone Macmillan Cancer Support Support Line: Freephone Cancer Research UK Freephone NHS Prescriptions NHS Choices 6

7 Questions? Make a note here This leaflet is available in audio, braille, large print and other languages. To request a copy, please telephone

8 Macmillan Breast Care Nurses Mid Cheshire Hospitals NHS Foundation Trust Leighton Hospital Crewe, Cheshire CW1 4QJ Direct Line: Revised and reprinted June 2018 Review June 2020 Ref: SC/MBCNS/