Types of Surgery: Axillary Lymph Node Dissection

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: January 22, 2002

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About Axillary Lymph Node Dissection

Rena Rowan Breast CenterThis "Helpful Facts" sheet is designed to give you basic information on axillary lymph node dissection. More detailed information can be provided by your doctor or nurse. If, you have other questions or would like additional information, please talk to your doctor or nurse.

What is the Lymph System?
The lymph system is important in 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 fluid is then filtered through the lymph nodes, which are clustered in various parts of the body. Lymph nodes act to filter out and trap bacteria, viruses, cancer cells, and other unwanted substances.

What is an Axillary Lymph Node Dissection?
The lymph nodes under your arm are called "axillary" lymph nodes. These lymph nodes drain and filter fluid from the arm and chest area. An axillary lymph node dissection is the surgical removal of these lymph nodes. This procedure is done to determine if the cancer has spread beyond the breast. If there is cancer in the lymph nodes, it may influence additional treatment recommendations.

Does Everyone with Breast Cancer Require an Axillary Lymph Node Dissection?
Very early breast cancer, such as ductal carcinoma in situ, is "noninvasive" breast cancer. This means that the abnormal cells are found only in the lining of the milk ducts or lobules of the breast and have not yet invaded the surrounding breast tissues, lymph vessels or blood vessels; therefore, these abnormal cells can not spread to other areas of the body. Patients with noninvasive breast cancers generally do not require an axillary lymph node dissection.

What are the Risks of an Axillary Lymph Node Dissection?
As with any surgery there is a risk of bleeding, infection and poor wound healing. Fluid or blood could accumulate around the breast or underarm area and require drainage. Numbness and tingling in the underarm and arm can occur due to nerves cut during surgery. Muscle tightness of the underarm and shoulder can occur. Lymphedema, or swelling of the arm, can occur weeks, months or years after surgery. There is also a life-long risk of developing arm infections following a lymph node dissection.

How Long Will I Be in the Hospital?
You will be discharged from the hospital within 48-72 hours of the surgery even if a mastectomy or lumpectomy is performed. If a mastectomy is performed with immediate reconstruction the hospital stay is usually four to five days.

How Will I Look and Feel After the Dissection?
You will have an incision in the underarm area. Initially there will be some swelling and discomfort. Drains, or thin plastic tubes with a plastic "balloon" at the end, will be in place to collect fluid from the breast and underarm area. The drain(s) will stay in for approximately one week. You or your family will need to learn how to care for these at home. A referral will be made for home care visits to assist you and your family in your care (visits may vary according to insurance). A "Preparing for Breast Surgery" class is held weekly at the Rowan Breast Center. The class provides an opportunity for you and your family to learn, before your surgery, how to care for your drains and incision. Check with your nurse or doctor to register for the class.

Your underarm and arm may be numb and tingling after the surgery. Most women get a significant amount of this sensation back, but not usually full sensation. Your skin may also feel tight on your chest and underarm area. This is due to the skin being pulled tightly during the surgery. Your skin has elastic components and will loosen as time goes on. Muscle tightness of the underarm and shoulder may also occur. Once your drains are removed, it will be important to exercise that arm. You will be shown some arm exercises at your first post-operative visit.



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