This article will outline the function of axillary lymph nodes and what happens when they are biopsied and dissected.
The Function of Axillary Nodes
The lymphatic system is comprised of lymph fluid, lymphatic vessels, and lymph nodes, as well as the spleen, tonsils, and adenoids. Lymph nodes are tiny organs that store white blood cells, called lymphocytes, that help fight infections and disease.
During a physical examination, healthcare providers will often examine the armpit to see if the axillary nodes are swollen. Around 75% of lymph fluid from the breasts drains into the axillary lymph nodes, making them important in the diagnosis of breast cancer.
If diagnostic tests (such as a mammogram) are indicative of possible breast cancer, axillary nodes may be surgically removed and examined to see if cancer is present. This is referred to as an axillary node biopsy. The biopsy can help your oncologist determine if cancer is present and begin the process of staging the disease.
Axillary Node Biopsy
A biopsy is a procedure in which sample tissue is removed to be tested by a pathologist in a lab. A common type of biopsy that’s used in breast cancer staging is called a sentinel node biopsy. A sentinel node biopsy is usually performed on an outpatient basis in a hospital or specialized surgical center.
Sentinal node biopsy starts with injecting dye in the area. The first node that absorbs the dye is called the sentinel node. It is the first in the string of lymph nodes into which cancer cells are filtered. Because it is the first, it is more likely to deliver a more accurate result than a lymph node that is farther away.
That node is sent off to a lab to see if it contains cancer cells. If the sentinel node does not have cancer, it is unlikely that other nodes will have cancer and further surgery is not typically considered necessary.
Axillary Dissection
If cancer is present in a sentinel node, an axillary dissection will be performed to remove additional lymph nodes. The lymph node dissection will determine how many lymph nodes contain cancer cells. This information is important for treatment planning. And the removal of axillary lymph nodes that contain cancer cells can help prevent breast cancer from spreading to other areas of the body.
Axillary dissection is a relatively quick procedure that’s done under general anesthesia. You will lie with your arm lifted over your head during the surgery.
For many women with breast cancer, this may be done at the same time as a lumpectomy or a mastectomy. During a typical axillary dissection, an average of two to 20 nodes are removed. The number of nodes affected is one of the key criteria for determining if the cancer is early (stages 1 to 2a) or advanced (stages 2b to 4).
Complications
Many women don’t experience any problems due to axillary dissection, but the surgery may cause complications. Women are typically asked to avoid lifting heavy objects during recovery.
A common complication of this surgery is lymphedema. This is swelling of the arm, hand, breast, or torso due to the disruption of lymph vessels. Lymphedema can be painful, and it may go away (with treatment) within 24 months.
The approximate risk of lymphedema following axillary dissection is 14%. This can increase to 33% if radiation therapy is used.
Axillary dissection can also cause loss of sensation in the breast or axilla, limited arm mobility, and muscle weakness. Most of these symptoms are temporary and will improve over time.
Get prompt medical attention if you have any of the following symptoms:
High feverInfection at the surgical siteRedness, painful swellingPus-like discharge
Summary
Axillary lymph nodes, located in the armpit, are part of the immune system. They help clear out disease-causing microorganisms. They can also be part of a breast cancer diagnosis. To learn if the breast cancer has spread from the breast, a breast cancer surgeon may remove axillary lymph nodes. A pathologist can determine if the cancer has spread by looking at the cells with a microscope.
A Word From Verywell
Axillary lymph node biopsy is often a standard procedure that’s part of diagnosing breast cancer. Although removing lymph nodes can have unpleasant side effects, such as lymphedema, their removal may also prevent breast cancer from spreading to other areas of the body. If you are having any fever, swelling, or redness at the surgical site, call your doctor right away to have it examined.
