Axillary lymph node clearance

Hi everyone

Hope you can help me. I had a single flat mastectomy in September followed by a course of chemotherapy which I finished last week. I’ll be having axillary lymph node clearance in a few weeks time and I’m not sure what to expect.

I had just assumed that it would be a day case, same as mastectomy, with no drains, but after deciding to Google the operation today I’ve discovered that most health authorities seem to keep patients in hospital for a few days. Was that the case with you? Did you have drains? Were there any complications? It seems to be a more serious operation than a mastectomy.

I will be seeing the breast surgeon next week but he’s not very forthcoming so I’ll need to ask the right questions to get answers. I’m starting a list. Anything you can suggest I should ask? Thanks. x

Hi there,
I have recently had this op and also had a bilateral mx with recon and sentinel node clearances two years ago.

The full node clearance op is similar in scale of op to mx. I was in hospital for two days this time and pain wise on heavy meds and sore arm but all very manageable (which I found was very similar to mx). I have one drain as opposed to two drains for mx.

Recovery wise back on my feet in a week. The big thing to watch for is protecting against lymphedema as taking out all nodes means a bigger jump in risk for this. And recovery wise you have to be much more careful with your arm as a result and exercises are really important to do after.

If possible before you go in for the op have a physio appointment and they can measure you with this new machine to set a baseline for the amount of fluid in your body. This is to measure you for risk of lymphedema. As this is helpful to see where you are after the operation.

Hope that helps! And best of luck. X

One other thing I forgot to mention if you do have affected nodes ask to get an MRI of the breast to see if there is any other things to watch out for. This is also helpful for the operation itself in the removal of the nodes.

Hi country girl

I had aaxillary clearance operation at the end of November. I went in as a day patient and didn’t have any drains. Took abit longer to recover than my first op which was lumpectomy and snlb but very similar

Hope all goes well for you

I had mastectomy june 2022 then clearance Aug 22. Home after about 3-4 hours, no pain relief needed, no drains… the exercises were tougher to do for sure and the stretch range less but not enough to stop me doing much. Putting the boot down on the car is the main difference-struggle with operated side but can live with that. Did get cording which physio helped with but no lymphoedema as yet. I am a bit more neurotic with gardening, wearing gloves, scratches etc but again, I can live with that. Good luck and I hope not as bad as you fear.
Tip: I got bamboo pillowcase on squishy pillow which was great to rest arm on-cool, soft, rested it in good position sitting or in bed… hospital also gave me a small heart shaped pillow to stop my arm rubbing on my side which helped when first home from hospital
Big hugs

Thank you for the replies and tips. That sounds better than I’d feared. Hope my authority treats it as a day case. I seem to be more worried about this than either the mastectomy and SLNB, or chemo. I know it’s just another hurdle to get over so will have to cope with it.

Maybe it’s because it means going back for more surgery (cancer cells found in all of the sentinel lymph nodes removed) when it would be good to move straight on to radiotherapy (which will come later). Another few months to get through. Treatment takes its toll after a while. I know it has to be done though. I’ve forgotten what normal life was like before all this. x

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Saw breast surgeon today and I’m booked in for surgery on 3 April. It will be a day case and there may be a small drain but that will be removed before I go home. Feeling much better now that I know more about what to expect. x

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Well, I was right to be worried because this surgery has been the worst part of my treatment so far and that includes mastectomy and four months of chemo. Had surgery 10 days ago and I have a seroma.

Rang BCN two days ago and she said that as long as it was soft, and not red or painful, it should be left to self-absorb as draining can cause infection and it will just re-fill anyway.

Two days on it is worse and feels fairly hard now and is bigger. It’s also painful to move arm and I can’t do the exercises very easily. Swelling is at front of underarm and above (non-existent) breast. I can’t put my arm straight down to side of body because of the swelling. Stitches are still intact.

Using heat on it several times a day (which nurse didn’t mention but I found on internet).

I have a telephone call with my surgeon on Monday so will see what he says. What have you done? Did you find that having it drained was the best option (if they agree to do it) or is it best to tolerate it until it goes down. I’m due to have radiotherapy in a few weeks time (no date yet) so don’t want this to delay treatment - because they won’t do it with seroma or because I can’t get my arms above my head as I can’t do exercises properly.

I’m really sorry this part of your treatment isn’t going well and causing you such discomfort.
It’s good you’re speaking to the surgeon on Monday.
I had a seroma that was drained first time then left to absorb second. It felt like pressing on a water bottle.
The fact that yours is hard and so painful, could it be infection as well as seroma? Do you have redness or temperature since call to nurses?
I think if you explain the impact it’s having on pain, exercise regime, life… I would think they would drain. They used needle into suction bottle, took 10-15 minutes, instant relief… hopefully that will be the same for you.
I would ask surgeon if possible to get face to face visit so they make decision after feeling/looking at, Rather than telephone call?
I hope you feel better soon :pensive:Laura

Thank you. I have normal temperature and no redness. Just hard and painful. The surgeon’s call on Monday is a routine follow-up after surgery to give me results and tell me what the next stage of treatment is, but he will have a nurse in the room with him. I will definitely ask for an appointment to go up to the hospital so they can look at seroma and I’ll emphasise how much it’s affecting me. Would prefer it to be drained if possible. x


My seroma came up after about 10 days and was like having a tennis ball under my arm, it kept swelling up during the day and would go down overnight, like you I put a warm bottle on it and slept with a small cushion under my arm and when sitting during the day.

I rang the breast care team and they told me to go straight in which I did, they checked it out and I didn’t have it drained, it took a few weeks but it went down on its own.

Definitely get it looked at if only to put your mind at rest.

Take care

Hi. I use a small cushion too. It’s reassuring to know that yours went down without intervention. If mine isn’t drained, I hope it will go down in time for radiotherapy. Every step of treatment is so stressful. Will get it checked out. Thanks. x

Hi @countrygirl1. I had a seroma after my ALND and it sounds similar to yours. I also used heat and by week 3 it had gone. Persist with warm compresses as it does help. If it gets unbearable they will drain it. Try and do some exercises as that helps too. Hope it eases soon. X

Hi. Seroma worse today so I have an appointment with the nurse tomorrow morning at the hospital to possibly have it drained. Will at least get it looked at face to face. Thanks. x

Hi. Just a quick update. Had seroma drained today. Nurse said it was too hard and painful, and was stopping me exercising. Still a little puffy but it is soft and feels much better. If it re-fills and becomes firm (which I’m told it will) I can have it drained again next week. May have to be done a few times but with longer intervals in between. Just need to crack on with the exercises now so I can have radiotherapy in a few weeks time. x

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