Lymph Node Dissection

• There are two types of lymph node dissection—standard axillary dissection and sentinel axillary dissection.
• Sentinel node dissection (the newer form) is only appropriate for women without any signs of underarm lymph node involvement.
  • The sentinel node is the first or "watchdog" node, which is the most likely to have cancer cells in it.
  • Dye or radioactive tracer materials are introduced into the breast. As they drain away from the breast into the armpit, the surgeon finds the lymph node or nodes that take up the dye or radioactivity first (the sentinel node or nodes).
• Standard axillary dissection (the "old standard" form) removes nodes from the underarm. It is the preferred approach if there are enlarged lymph nodes in the armpit that may have breast cancer cells in them. Sometimes this procedure is done after a sentinel lymph node dissection, if cancer cells were found during the first surgery.
  • The standard axillary lymph node dissection starts at the bottom of the armpit near the breast. Then the surgeon goes under and above the pectoralis major muscle to cover the middle and top of the armpit. Usually, only the bottom two (of three) levels of axillary lymph nodes are removed.
• Lymph node surgery may be done at the same time as breast surgery
  • With a modified radical mastectomy, lymph nodes are removed together with the breast.
  • With lumpectomy and lymph node dissection, the lymph nodes are usually removed through a separate incision.

Read more about lymph node dissection.