What is Axillary Clearance?

Axillary clearance, also known as axillary lymph node dissection (ALND), is a surgical procedure used to remove lymph nodes from the armpit (axilla). This is done to check for or treat the spread of breast cancer. The lymph nodes in the axillary region are often the first place where breast cancer cells spread beyond the breast tissue, making this surgery an important step in accurate staging and long-term treatment planning.

The number of lymph nodes removed may vary, but typically, 10 to 20 lymph nodes are excised for thorough evaluation. The procedure is more extensive than a sentinel lymph node biopsy, which removes only the first few draining nodes.

Why is Axillary Clearance Done?

Axillary clearance is usually recommended when:

• A biopsy has confirmed cancer in the axillary nodes
• Cancer has spread beyond the sentinel lymph nodes
• There is clinical or radiological evidence of lymph node involvement
• There's a recurrence of cancer in the axilla
• As part of surgical management for locally advanced breast cancer

By removing multiple lymph nodes, doctors can determine how far the disease has spread and what additional treatment—such as chemotherapy or radiation—is needed. It also helps reduce the risk of further cancer spread within the lymphatic system.

How is the Procedure Performed?

Axillary clearance is performed under general anesthesia and usually takes about 60–90 minutes. A small incision is made in the armpit, through which the affected group of lymph nodes is carefully removed. The procedure is often performed alongside breast surgery—such as a lumpectomy or mastectomy—for comprehensive cancer management.

Once the nodes are removed, the area is examined for bleeding, and a drain may be placed temporarily to prevent fluid buildup. The incision is closed with sutures, and the removed lymph nodes are sent to a pathology lab for examination.

What to Expect After Surgery

Recovery from axillary clearance is generally smooth, though it requires attentive post-operative care. Most patients are hospitalized for a day or two, especially if a drain is placed. Mild pain, swelling, and bruising in the armpit area are common during the initial healing phase.

Post-operative care includes:

• Pain management with oral medications
• Wound care and instructions to keep the area clean
• Drain management, if applicable
• Arm exercises to prevent stiffness and maintain shoulder movement
• Regular follow-up appointments to check for infection, healing, and pathology results

Dr. Kanmani provides detailed guidance and closely monitors your recovery, ensuring a safe and supportive healing process.

Possible Risks and Side Effects

While axillary clearance is a safe procedure in expert hands, some side effects can occur due to the nature of lymph node removal. These may include:

• Lymphedema – swelling of the arm due to fluid accumulation
• Temporary numbness or tingling in the upper arm
• Reduced arm mobility or stiffness
• Increased risk of infection in the affected arm

To minimize these risks, patients are taught gentle exercises, arm care techniques, and how to recognize early signs of complications. When performed skillfully and combined with rehabilitation support, most patients regain excellent function and comfort.

Axillary Clearance vs. Sentinel Lymph Node Biopsy

While both procedures focus on evaluating lymph node involvement, they differ in scope:

• Sentinel lymph node biopsy removes only the first 1–3 nodes that drain the tumor.
• Axillary clearance removes a larger group of lymph nodes for broader analysis.

Axillary clearance is typically performed when the sentinel nodes show cancer involvement or if imaging/biopsy indicates that multiple nodes are likely affected. Your doctor will discuss which approach is best based on your diagnosis and overall treatment plan.

Why Choose Dr. Kanmani Govindrao Telkar?

Dr. Kanmani Govindrao Telkar is a trusted and experienced general and breast surgeon, known for her precision, gentle surgical techniques, and patient-first approach. With an MBBS and MS in General Surgery, she is highly skilled in managing complex breast cancer cases, including axillary clearance.

Patients choose Dr. Kanmani because she:

• Explains procedures clearly, helping you feel informed and at ease
• Performs surgery with minimal scarring and maximum safety
• Coordinate care with oncologists, physiotherapists, and counsellors
• Offers comprehensive follow-up, ensuring full recovery and emotional support

Her practice focuses on not just treating the disease, but on empowering the patient, both physically and emotionally.

Reclaim Control with Expert Care

Axillary clearance is a vital part of breast cancer surgery for many women. While it may sound intimidating, in the hands of an experienced surgeon like Dr. Kanmani, it becomes a safe and effective procedure that gives you clarity, control, and peace of mind.

Whether you're newly diagnosed or need further evaluation after a sentinel lymph node biopsy, Dr. Kanmani will guide you through the process with compassion, clarity, and expert care.

Book your consultation today to discuss your treatment options and take the next step with confidence.