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Axillary Lymph Node Dissection

CONTENTS:

Description of your surgery

Before your surgery

On the day of your surgery

After your surgery

Your Follow-up care

 

Description

 

This surgical procedure removes the lymph nodes in the axilla (armpit). 

1.       After reporting to the surgery reception area, you will be moved to the preoperative area.  You will change, receive an IV and meet with your anesthesiologist.

2.       You will then be brought to the operating room.  You will receive antibiotics and the general anesthesia.  Once you are asleep, your surgeon will make an incision at the lower border of the hairline in the axilla (armpit) and remove the lymph nodes.  These will be sent for testing.

3.       A drain will be placed to prevent fluid accumulation.  This usually stays in place for 1-2 weeks, depending on how much fluid is draining.  Your surgeon will make this decision at your follow-up visit.

4.       Your incision will be closed with sutures, which are under the skin and dissolve e on their own, then bandaged.

5.       You will learn how to take care of your incision and drain before you leave the hospital.

6.       The most common risks of the surgery include bleeding, infection and a 10% risk of chronic swelling of the arm.  Your surgeon will have discussed this with you in the office.

 

Before Your Surgery

 

Pre-testing: 

You may need pre-testing when your surgery is scheduled in the Day Stay Unit.

 

Scheduling:

  • You will be called the week before your surgery by a nurse from the Anesthesia Department. She will ask you questions to determine if you need any pre-testing or need to speak with the anesthesiologist.
  • Your pre-tests are scheduled for

Day _________ Date __________ at  _______  am  pm

 

On the day of your pre-testing:

Report to Baystate Medical Center

                Chestnut Surgery Building

                759 Chestnut Street.


Use valet parking if parking is difficult.

Call our office at 413-794-4262:  

  • If you have a emergency.
  • If you have questions.
  • If you are getting sick.  (We may need to postpone your surgery.)

 

The night before your surgery:

  • Do not eat or drink after midnight (includes no gum or hard candy).

 

The Day of Your Surgery

 

  
Your surgery is scheduled for:

Day ___________  Date ____________

Arrival time* ___________

*Arrival time is 1½ hours before your 

surgery is scheduled. 

 

 

On the day of your surgery:

  • Do not eat or drink anything (no gum or hard candy).
  • Unless otherwise instructed, take your normal   medications with just a sip of water.
  • Wear or bring a supportive bra. You will need to wear this bra when you go home. The bra will provide support that will decrease the amount of bruising and pain.
  • Do not wear fingernail polish or makeup.
  • Report to: 

      ________________________________

________________________________

 

            Hospital staff will escort you to:

Operating Room at __________ AM  PM

  • After your surgery, you will be sore.  Arrange for someone to drive you home.              

 

Your Test Results

We will have the test results (pathology report) on your biopsy in about one week. Your doctor will discuss your test results with you at your follow-up visit.

 

After Your Surgery

 

  
WARNING SIGNS!

Call us immediately at 413-794-4262 if you have any of the following:

Redness, pus, or enough blood to soak the bandage at the incision.

Severe pain that will not go away after taking your pain medicine.

Temperature over 101.5°F.

 

 

  • Driving. We do not recommend you drive until after you are evaluated by your doctor during your follow-up visit.
  • Activity. Avoid activities that  increase movement to the area.
  • Pain. Some pain is normal. You will receive a prescription for a strong narcotic pain medicine. If you prefer a milder pain medicine, take 2 extra strength Tylenol (acetaminophen) every 4 to 6 hours. During the first 48 hours, avoid medicines that can cause bleeding (like aspirin or Motrin).
  • Clothing.   If you have breast surgery, wear a bra at all times during the first 48 hours after surgery. This prevents movement that causes pain and bleeding.
  • Showering. You may shower 48 hours after your surgery. (Remove the outer bandage first; afterwards, pat dry.)
  • Sleeping. Avoid sleeping on the side of your operation since this may cause more swelling.
    Wear your bra.
  • Bruising. Bruising is normal. This will go away over a couple of weeks. 
  • Swelling. If your breast feels swollen, you may place an ice pack over the incision.

 

Your Follow-Up Care

 

Checking Your Incision. A little blood on the bandage is normal. If the bandage becomes soaked with blood or other fluids, please call our office immediately at 413-794-4262.

 

Removing Your Bandage. Unless otherwise directed, you may remove the outer bandage
24 hours after surgery. 

When you remove the bandage, there will be a row of small white tapes directly on the incision.  Please, do not remove these strips of tape before your follow-up visit with your doctor.

Keeping Your Incision Clean. After you remove the bandage, you may get the incision area wet (48 hours after surgery). Pat the incision dry.

Do not take  baths that would soak the area until after you have been evaluated by your doctor during your follow-up visit.

Occasionally, you may notice a hardened area where the tissue was removed. This is normal. As the area heals it first becomes hard, then softens over the next several months.

 

  
YOUR FOLLOW-UP VISIT

 

Please call 413-794-9338 to schedule 

a follow-up visit with your doctor.

   Day _________ Date __________ at  ____ am  pm

On the day of your appointment:

Report to Baystate Medical Center
Comprehensive Breast Center

3400  B  Main Street