Lymph Node Surgery
If you have an invasive breast cancer, your surgeon will need to check for cancer in one or several lymph nodes in the armpit on the side of the body where the cancer was found. Lymph nodes are organs that help the body filter out waste, bacteria and damaged cells.
These are the most common types of lymph node surgery.
To find out whether cancer is in the lymph nodes, a doctor removes a few lymph nodes from your underarm where the cancer is most likely to travel first. These are called the sentinel nodes.
Before surgery, you will get an injection of dye or dyes into your breast. At the time of surgery, the surgeon will look for the lymph nodes that have taken up the dye. The surgeon will send the sentinel nodes to a pathologist to test whether they have cancer. If they do not, no more nodes will be removed. If they do, your surgeon may remove more underarm lymph nodes, either at the time of your sentinel node biopsy or during another surgery.
Sentinel lymph node biopsy is usually not offered if you have:
- a locally advanced cancer, or a very large tumor that has spread within your breast
- inflammatory breast cancer
- DCIS, and you plan to have a lumpectomy
If cancer is found in your lymph nodes, you may need an axillary lymph node dissection, or removal of most of the lymph nodes in the armpit. An axillary lymph node dissection will help your doctors stage the cancer and recommend treatment.
Axillary dissection is a more extensive surgery than sentinel node biopsy. It has a higher risk for side effects such as shoulder stiffness and lymphedema. To address these side effects, your doctor may refer you to a physical therapist or a lymphedema specialist.
This type of surgery may not be recommended if you:
- have no cancer in the lymph nodes
- have cancer in 1 or 2 lymph nodes, and you plan on having a lumpectomy followed by radiation therapy
- plan to have radiation to the armpit area
Lymph node surgery is an important part of assessing and treating breast cancer. But as with any surgery, lymph node surgery can have serious side effects. Talk with your doctors about these risks before you have surgery. They can help you understand the benefits of surgery over the risks of side effects.