Axillary Lymph Node Dissection Surgery

Breast cancer can sometimes spread to the nearby lymph nodes in the underarms (axillary)- such lymph nodes must be removed to stop the cancer from spreading in the body.
Axillary lymph node dissection (ALND) is a procedure to remove such lymph nodes.

What to Expect Axillary Lymph Node Dissection Surgery

ALND can remove lymph nodes located below, above or underneath a muscle that runs along the side of the upper chest- this muscle is known as the pectoralis minor muscle.

There are three levels of axillary lymph nodes and possible solutions for a surgeon-

Level I — remove all the tissue below the muscle

Level II — remove the tissue directly underneath the muscle

Level III — remove the tissue that is above the muscle (this is the most aggressive surgery)

Cancer cells are usually removed from the breast at the same time as ALND.


What happens during Axillary Lymph Node Dissection (ALND) and after the surgery?

An axillary lymph node dissection usually removes nodes in levels I and II. For patients with invasive breast cancer, this procedure usually accompanies a mastectomy- it may be done at the same time as, or after, a lumpectomy through-a separate incision.

Based on the surgeon’s physical exam and other indicators about the possibility that cancer has spread to the lymph nodes, the surgeon will generally remove five to thirty nodes during a traditional axillary dissection. The total number of affected lymph nodes is more important than the extent of cancer in any one particular node.

As with any other surgery, ALND also come with a risk of side effects. For example, the removal of lymph nodes may increase the risk of lymphedema. This condition occurs as a result of lymph fluid that collects in the area where the lymph nodes used to be.