Axillary lymph node dissection

Axillary lymph node dissection (ALND) is a surgical procedure performed to remove lymph nodes located in the axilla (armpit). It is commonly performed in the treatment of breast cancer to prevent the spread of disease to other parts of the body.

Procedure

The procedure involves the removal of level I and II axillary lymph nodes, which are located beneath the pectoralis minor muscle. In some cases, level III nodes (located above the pectoralis minor muscle) may also be removed. The number of lymph nodes removed during an ALND can vary, but typically ranges from 10 to 40.

Indications

ALND is typically indicated in patients with breast cancer who have clinically positive axillary lymph nodes, confirmed by preoperative biopsy or sentinel lymph node biopsy. It may also be performed in patients with negative sentinel lymph nodes if they have a high risk of axillary disease.

Risks and Complications

Like all surgical procedures, ALND carries some risks. These can include lymphedema, a condition characterized by swelling in the arm due to damage to the lymphatic system, as well as infection, seroma formation, and shoulder dysfunction.

Alternatives

Alternatives to ALND include sentinel lymph node biopsy (SLNB), a less invasive procedure that involves the removal of only the first few lymph nodes into which a tumor drains. SLNB is often performed in patients with early-stage breast cancer and no clinical evidence of axillary lymph node involvement.

See Also

• Breast cancer
• Lymph node
• Sentinel lymph node biopsy