Lymph nodes are tiny nodules situated throughout the body that drain lymph fluid and trap and eliminate bacteria, viruses and cancers cells. For women with breast cancer, the presence or absence of cancer cells in lymph nodes found under the arm (axillary nodes) plays an important role in determining whether cancer has spread, and how aggressive treatment should be. There are three levels of axillary nodes. Level I is the bottom level, below the lower edge of the pectoralis minor muscle. Level II lies underneath the muscle, and level III sits above the muscle. In a standard axillary node dissection, nodes in level I and II are removed. Most women with early-stage breast cancer are good candidates for a similar but less invasive procedure called a sentinel node biopsy.
An axillary node dissection may be performed at the same time as a mastectomy, or at the same time or after a lumpectomy. If you are having an axillary node dissection, you will receive general anesthesia so you can sleep through the procedure. The surgeon removes a pad of fatty tissue in the armpit that contains the lymph nodes, which will then be examined by a pathologist. Most women will have anywhere from five to thirty nodes removed, with the average being ten. A drain is usually placed in the surgical cavity and attached to a reservoir. The reservoir collects the extra fluid that tends to build up over the next seven to ten days. You will go home with the drain and we will arrange for a visiting nurse to assist you in your post-surgical care. Your surgeon will tell you how many nodes were removed during your surgery and how many were found to be positive nodes (have cancer present). The number of positive nodes is important when determining your treatment plan. Your Comprehensive Breast Health Center team will talk with you in more detail about what to expect when having an axillary node dissection, and answer all of your questions.
Learn more about the patient-centered, high-quality approach to breast cancer care provided to patients diagnosed and treated at Lahey Hospital & Medical Center.