What is axillary lymph node dissection?
At The Iowa Clinic, we prioritize thorough lymph node evaluation as an essential component of breast cancer treatment. Axillary lymph node dissection is a surgical procedure used to remove lymph nodes from the axilla (underarm area) that may be affected by breast cancer metastasis for detailed examination and staging of breast cancer.
It is typically recommended when cancer cells are detected in the sentinel lymph node(s) during sentinel node biopsy or when there is a high risk of lymph node involvement based on tumor characteristics.
What happens during an axillary lymph node dissection procedure?
During an axillary lymph node dissection procedure, the following steps typically occur:
- Preoperative Evaluation: Before surgery, you will undergo preoperative evaluation, which may include imaging studies (such as ultrasound or MRI) and discussion with your surgical team about the procedure, risks, and expected outcomes.
- Surgical Incision: An incision is made in the axilla to access the lymph node basin. The size and location of the incision may vary depending on the extent of lymph node dissection required.
- Lymph Node Removal: The surgeon carefully identifies and removes the lymph nodes in the axillary region, including levels I, II, and III, which are divided into anatomical zones based on their location relative to the pectoralis minor muscle.
- Pathological Evaluation: The removed lymph nodes are sent to the
pathology laboratory, where they are examined under a microscope for the presence of cancer cells. The number of lymph nodes involved and the extent of metastatic spread are important factors in determining cancer staging and treatment planning.
What are the benefits of axillary lymph node dissection?
While ALND is often necessary for accurate staging and treatment of breast cancer, it does have potential benefits and considerations:
- Accurate Staging: Axillary lymph node dissection provides a comprehensive evaluation of the extent of lymph node involvement, which is crucial for accurate cancer staging and treatment planning.
- Risk Reduction: By removing potentially cancerous lymph nodes, axillary lymph node dissection reduces the risk of cancer recurrence in the axillary region and provides valuable prognostic information for patient management.
- Treatment Guidance: The results of axillary lymph node dissection help guide further treatment decisions, such as adjuvant chemotherapy, radiation therapy, or targeted therapy, based on the extent of lymph node involvement and other tumor characteristics.
What happens after an axillary lymph node dissection?
After axillary lymph node dissection, you will undergo a period of recovery, which may involve pain management, activity restrictions, and follow-up appointments with your surgical team. Depending on the extent of lymph node involvement and other tumor characteristics, further treatment options may be recommended to reduce the risk of cancer recurrence.