How Many Nodes Removed?

You can usually get enough information by having ten lymph nodes taken out. But there are a few things to keep in mind:

• Your surgeon will probably remove any nodes that feel cancerous, even if that ends up being more than ten nodes.
• During a "standard" axillary lymph node dissection, the surgeon removes an irregular pad of fatty tissue in the armpit that contains the lymph nodes. The lymph nodes are embedded in this fat, and can often feel just like the fat. Often the surgeon can't count all the lymph nodes at the time of surgery. For this reason, you probably won't know how many nodes were removed and how many of those were "positive" (involved in the cancer) until the pathologist analyzes the tissue.
• The pathologist has to look carefully through the piece of fatty tissue taken from the axilla to find all of the lymph nodes.
• How many lymph nodes are removed depends just as much on your normal anatomy as it does on the surgeon's and pathologist's skill. Every woman has a different number of lymph nodes under her arm—some may only have five nodes and others may have over thirty.
• To increase the likelihood of removing the most likely-to-be-involved lymph nodes during this procedure, your surgeon may use a tracer or dye (similar to what is done during a sentinel lymph node dissection).

For some women with a low to moderate risk of lymph node involvement, there is a new, usually less extensive, type of surgery called sentinel lymph node dissection.