Lymph after Node Removal

Last Modified: May 8, 2009

Question

Dear OncoLink "Ask The Experts,"

Where does the lymph of the left arm go when the axillary nodes have been removed?

Answer

Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:

Lymph node removal and radiation therapy to the local tissue leave the lymph node bed less able to maintain fluid balance. Not all of the lymph nodes are removed with axillary resection. Following radiation therapy to the involved area, we do consider those lymphatics unable to maintain their function. The lymphatic quadrant includes the chest wall (front and back), any residual breast, and the arm and hand on the same side.

Medical evidence shows that there is “sharing” of function/fluid with the lymph nodes in the opposite arm and in the groin on the same side. These lymph node beds compensate for the loss of function in the axillary lymph nodes affected by cancer treatments. However, the ability of each person's body to compensate varies considerably.
There are also different lymphatic pathways that occur in some individuals. A certain percentage of people actually drain to the lymph nodes in the clavicle (collar bone area). In these individuals, removal of the axillary lymph nodes is less problematic.

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