Lymph Node Removal: What It Means?

Facing breast cancer surgery can be overwhelming. One of the steps your doctor might recommend is lymph node removal which is a procedure that plays a crucial role in cancer staging and treatment but can also bring long term effects.

Let’s walk through why it’s done, what happens to your body, and how you can take care of yourself afterward.

What Happens When Lymph Nodes Are Removed?

During breast cancer surgery, your surgeon may remove one or more lymph nodes, often from the axillary area (the armpit region). These small, bean-shaped structures filter lymph fluid and help your body fight infections. Removing them allows your doctor to check if cancer has spread beyond the breast and helps guide further treatment decisions.

In my own personal story, my triple negative cancer affected my left breast, and although the right side only had some benign tumors, my doctors recommended to remove all the lymph nodes from the left side and three from the right side to be sure there weren’t any microscopic cancer cells hiding there. Sometimes, cancer cells can be too small to detect during scans. It’s a tough decision, and ultimately it’s up to you to choose whether or not to have lymph nodes removed. The idea of cancer spreading terrified me, and I didn’t want to risk going through this again, so I chose to go ahead with the surgery on both sides.

How Lymph Node Removal Affects the Body

Lymphedema

Lymph node removal can disrupt the normal flow of lymph fluid, leading to a condition called lymphedema. This is swelling and it's usually in the arm or chest area that is caused by fluid buildup. It can range from mild to more noticeable and sometimes requires special therapy or compression garments to manage. While lymphedema can be a significant challenge, it’s generally considered less risky than leaving cancerous cells in place, as untreated cancer could spread and become life-threatening.

Reduced Immune Function

Lymph nodes play a key role in your body’s defense system by filtering out harmful substances and helping fight infections. When some of these nodes are removed, your body’s immune surveillance in that area can be reduced, making it slightly harder to fight off infections. Even though the immune system may be affected, the potential benefit of removing cancer cells that could spread is often more important for overall survival.

Range of Motion

The axillary lymph nodes are located near nerves and muscles that control arm movement. Removing these nodes can sometimes cause stiffness, reduced range of motion, or a sensation of tightness in the shoulder or arm. Physical therapy and gentle exercises can help restore mobility over time. Although these physical side effects are real, they’re usually a better trade-off than the possibility of cancer spreading to distant organs, which would be far more dangerous.

Pros and Cons of Removing Lymph Nodes vs. Letting Cancer Spread

Removing Lymph Nodes

The main benefit of removing lymph nodes is that it helps prevent the cancer from spreading to other parts of the body. It also gives your doctor important information about the stage of your cancer, which is essential for planning further treatment. However, the downside is the potential for long-term effects like lymphedema, reduced immune function, and changes in arm movement.

Letting Cancer Spread

Choosing not to remove lymph nodes can allow cancer cells to travel through the lymphatic system to distant organs. This can make the cancer harder to treat and more dangerous because once cancer spreads beyond the lymph nodes, it may affect critical organs like the lungs, liver, or bones. While some patients may worry about the side effects of surgery, like lymphedema, reduced immune function, or limited range of motion, it’s important to weigh those risks against the possibility of cancer spreading. Even though surgery may bring challenges, leaving lymph nodes in place with potential cancer cells inside them can lead to a much more serious and harder to treat situation.

A Closer Look: Anatomy and Surgery

The axillary lymph nodes are grouped into levels based on their location in relation to the pectoralis minor muscle. During breast cancer surgery, surgeons often perform either a sentinel lymph node biopsy (removing the first few nodes to which cancer would likely spread) or an axillary lymph node dissection (removing more nodes if cancer is found). Your doctor will show you diagrams showing these nodes and how they are removed to help you understand the procedure. I found a lot of comfort going through youtube videos to follow the procedures and fully understand what I was about to experience.

Something to Think About

It’s normal to feel nervous or unsure about lymph node removal. Remember, your surgical team will help guide you through the process and monitor you for any side effects. Talk to them about lymphedema prevention, arm exercises, and infection precautions to keep yourself healthy.

Sources

American Cancer Society. “Lymph Node Surgery for Breast Cancer.” 

https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer.html

American Cancer Society, 2023. 

https://www.cancer.org/cancer/types/breast-cancer/treatment.html

Mayo Clinic. “Lymphedema.” Mayo Clinic, 2023. https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682

National Cancer Institute. “Sentinel Lymph Node Biopsy.” National Cancer Institute, 2023. 

https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet