What is Axillary Lymph Node Dissection?

Axillary Lymph Node Dissection (ALND) is a surgical procedure in which lymph nodes are removed from the underarm (axilla) to determine whether cancer has spread beyond its original site. Lymph nodes are part of the lymphatic system, responsible for filtering harmful substances such as bacteria, viruses, and cancer cells.

ALND is most commonly performed in patients with breast cancer, but it may also be required for other cancers such as melanoma or lymphoma. By removing and analyzing the lymph nodes, doctors can accurately stage cancer and plan the most effective treatment approach.

Indications for ALND

Your doctor may recommend Axillary Lymph Node Dissection when:

• Breast cancer has spread or is suspected to have spread to the axillary lymph nodes.

• Clinically positive lymph nodes are detected through imaging or physical examination.

• Metastasis (cancer spread) is suspected in the axillary region.

• Melanoma or other cancers such as sarcoma or lymphoma are affecting the lymph nodes.

This procedure plays a critical role in cancer staging, guiding decisions about surgery, chemotherapy, radiation, or targeted therapies.

Causes Requiring Axillary Lymph Node Dissection

The main reason for undergoing ALND is the spread of cancer cells to the lymph nodes. Common causes include:

• Breast Cancer: The leading indication for ALND, especially when cancer has moved beyond the breast tissue.

• Melanoma: Aggressive skin cancers can spread to nearby lymph nodes.

• Other Cancers: Conditions such as sarcoma or lymphoma may also involve the axillary lymph nodes.

Symptoms Suggesting Lymph Node Involvement

Patients may experience certain symptoms before ALND is advised, such as:

• Swelling or lumps in the underarm (enlarged lymph nodes).

• Pain or tenderness in the axilla, especially with arm movement.

• Skin changes such as redness, warmth, or thickening over the lymph node area.

• Restricted arm movement or discomfort when raising the arm due to swollen lymph nodes.

Risks and Possible Complications

While ALND is an effective diagnostic and therapeutic procedure, it may carry some risks:

• Lymphedema: Swelling in the arm or hand caused by disrupted lymphatic drainage.

• Infection: Like any surgery, there is a risk of infection at the incision site.

• Nerve Injury: May cause numbness, tingling, or weakness in the arm.

• Persistent Pain: Some patients may experience ongoing discomfort after surgery.

Doctors take all necessary precautions to minimize these risks, and post-surgery rehabilitation can significantly improve recovery outcomes.

FAQs About Axillary Lymph Node Dissection

Q1. Is ALND always necessary for breast cancer?
Not always. In some cases, a less invasive procedure called sentinel lymph node biopsy (SLNB) may be sufficient if cancer has not spread extensively.

Q2. How long does recovery take after ALND?
Most patients recover within a few weeks, but swelling and stiffness may take longer to resolve with proper physiotherapy.

Q3. Can ALND cause permanent arm swelling?
Lymphedema is a possible complication, but with early physiotherapy and lifestyle modifications, the risk can be managed effectively.

Q4. Is ALND performed under general anesthesia?
Yes, the procedure is usually performed under general anesthesia.

Q5. How many lymph nodes are typically removed?
The number varies, but usually 10–20 lymph nodes are removed for accurate staging and treatment planning.