The literature was examined up until mid-2000. However, Level I evidence is not available for all areas of practice and for some recommendations the working party considered it appropriate to base recommendations on other levels of evidence. Most women diagnosed with invasive breast cancer currently undergo axillary dissection. Some of these women will also receive axillary irradiation.
Axillary dissection is used to stage the cancer to determine further treatment.
The current rationale for axillary treatment, by dissection or irradiation, is that it is used to reduce the risk of axillary recurrence 5 and possibly increase survival. However, these techniques have a number of side effects with particular concern focusing on lymphoedema - both together and separately. It is clear that the lymphoedema of the arm is more prevalent in women who have had both axillary dissection and axillary irradiation following a diagnosis of breast cancer. There is considerable confusion among women about the role of axillary dissection and axillary irradiation. There is also evidence of considerable variation in practice across Australia.