Axillary Lymph Node Dissection

Last Modified: December 4, 2005

Dear OncoLink "Ask The Experts,"
I have been diagnosed with an invasive breast cancer on my left side. The doctor wants to do an axillary lymph node dissection. Can you tell me what this entails?

Nancy J. O'Connor, MSN, CRNP Oncology Nurse Practioner for Breast Surgery at the Rowan Breast Center of the Abramson Cancer Center of the University of Pennsylvania, responds:

The lymph system is part of your body's defense against infection. It is made up of lymph vessels and lymph nodes. The lymph vessels collect fluid and protein from surrounding body tissues. The lymph nodes filter the fluid, trapping bacteria, viruses or even cancer cells. Because of this, lymph nodes in the armpit (axillae) are routinely checked as a standard part of breast cancer surgery for women who have invasive breast cancer. If breast cancer is non-invasive (in-situ ) then the lymph nodes are not routinely checked, though there are circumstances in which it would be recommended.

The lymph nodes clustered under the arm drain fluid from both the breast and arm. An axillary dissection removes the majority of lymph nodes, though not all (there are 3 levels of lymph nodes in the axilla, and the lymph node dissection removes levels one and two). On average, 15-25 lymph nodes are removed during an axillary lymph node dissection, though everyone is different and you may have more or less than that.

This procedure is more than a sentinel lymph node biopsy and most women stay overnight in the hospital. It is more uncomfortable and you may notice numbness underneath the upper part of your arm. The pain is usually nerve related and it is not uncommon to feel shooting burning pains or sensations as you are healing. There is also a temporary drain, which you will have to take care of at home. The drain usually stays in approximately 7-10 days. Most women do just fine caring for these drains at home, though they can be annoying!