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Axillary clearance

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Axillary lymph node clearance entails complete removal of all lymph nodes as opposed to the selective sampling of a few. It has the advantages of:

  • more thorough staging of axillary metastasis than sampling alone
  • theoretically less risk of local recurrence within axilla

However, it has a number of negative aspects:

  • up to half of all patients treated with axillary clearance have no evidence of axillary disease; this group have had an unnecessary procedure with its associated morbidity
  • there is increased morbidity relative to sampling alone, for example, nerve damage and lymphoedema; for this reason, nodal clearance should not be combined with radiotherapy

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