Axillary Surgery in Breast Cancer

FAQs

Learn about sentinel lymph node biopsy, axillary clearance, and de-escalation in breast cancer surgery.

Understanding Axillary Surgery in Breast Cancer

The lymph nodes in the armpit (axilla) are often the first place breast cancer can spread. Checking these nodes helps with:

Staging breast cancer – confirming whether cancer has spread.
Guiding systemic therapy – chemotherapy, hormone therapy, or targeted therapy may depend on node involvement.
Local control – in some cases, removing affected nodes reduces the chance of recurrence in the armpit.

Sentinel Lymph Node Biopsy (SLNB) in Perth

The biggest advance in axillary surgery is the sentinel lymph node biopsy.

The sentinel node is the first lymph node that cancer is likely to spread to.
A tracer or dye is used to identify these nodes.
Only a few nodes are removed through a small incision.

If no cancer is found in the sentinel nodes, most patients can avoid further axillary surgery. This makes sentinel node biopsy the gold standard staging procedure in early breast cancer.

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Axillary Clearance – When Is It Still Needed?

An axillary clearance (removal of most lymph nodes in the armpit) was once standard for breast cancer surgery. Today, it is reserved for:

Multiple positive nodes on biopsy or imaging
Extensive disease beyond the sentinel nodes
Cases where cancer cannot be controlled with radiotherapy or systemic therapy

Modern trials show that for many patients, axillary clearance does not improve survival compared with sentinel node biopsy alone, as long as systemic therapy and radiotherapy are given.

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De-escalation of Axillary Surgery

“De-escalation” means reducing the extent of surgery when it is safe to do so.

Benefits of de-escalated axillary surgery include:

Lower risk of lymphedema (arm swelling)
Less shoulder stiffness and pain
Faster recovery and return to normal activities
No compromise in long-term cancer outcomes

This modern approach has been shaped by large international clinical trials, and is now standard practice in Perth and around the world.

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How Axillary Surgery Affects Systemic Therapy Decisions

The results of axillary surgery help guide the overall treatment plan:

Chemotherapy – node-positive disease often strengthens the case for chemotherapy.
Hormone therapy – remains essential for hormone receptor–positive cancers, regardless of nodal status.
Targeted therapies – certain drugs (e.g., CDK4/6 inhibitors, PARP inhibitors) may be recommended based on lymph node involvement.

A sentinel lymph node biopsy usually provides enough information for oncologists to recommend the right systemic therapy, without the need for a full axillary clearance in most women.

Axillary Surgery in Perth – What Patients Need to Know

If you have been diagnosed with breast cancer, you may not need extensive axillary surgery.

Sentinel node biopsy is usually the first step.
Axillary clearance is only recommended when necessary.
De-escalation strategies aim to give you the best cancer outcomes while reducing side effects.

Book a Consultation in Perth

Every breast cancer is unique. The right axillary surgery depends on your diagnosis, tumour biology, and personal situation.

📍 As a specialist breast surgeon in Perth, I provide tailored advice on sentinel lymph node biopsy, axillary clearance, and de-escalated breast cancer surgery.

👉 Contact my clinic to book a consultation and discuss your treatment options.