Surgical removal of all axillary lymph nodes constitutes an Axillary Dissection. We assess every patient preoperatively for evidence of cancer in the axillary lymph nodes. If cancer is found by Ultrasound Lymph Node Needle Biopsy before surgery or is detected during the operative sentinel node procedure, then all axillary lymph nodes need to be removed. This procedure is well tolerated, but can result in numbness and sensation changes in the armpit and upper arm. Lymphedema is also an associated risk with any axillary surgery.
A landmark study was published in February 2011 in the Journal of the American Medical Association that investigated whether certain patients benefit from removal of all axillary lymph nodes when the sentinel node biopsy showed the presence of cancer within the sentinel nodes. In patients with relatively small breast cancers undergoing a lumpectomy and subsequent radiation therapy to the same breast, there was no improvement in survival or recurrence of cancer in patients that had a "completion axillary node dissection" when compared to a sentinel node biopsy alone. Our practice offers this "less invasive approach" to appropriate patients who are found to have cancer in their sentinel lymph node. Such patients can avoid the risk of arm lymphedema and sensation loss in the arm pit and upper arm that can occur with a conventional axillary node dissection.
NVBS is a division of Drs. Farr, Wampler, Henson, Williams, Dougherty, Brown, Ltd.