Breast cancer treatment often involves procedures focused on the armpit, specifically the lymph nodes. This is because breast cancer cells can spread to these nodes, a process called metastasis. Two common procedures addressing this are axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). Understanding these procedures is crucial for patients facing a breast cancer diagnosis.
What is Axillary Lymph Node Dissection (ALND)?
Axillary lymph node dissection (ALND) is a surgical procedure where the surgeon removes all lymph nodes from the underarm (axilla). This is a more extensive surgery than SLNB and is typically performed when there's a high suspicion of cancer spread to the lymph nodes, perhaps indicated by a palpable lump or other imaging findings. The removed lymph nodes are then sent to a pathology lab for examination to determine if cancer cells are present.
What are the risks associated with ALND?
ALND, while effective, carries potential risks. These include:
- Lymphedema: This is swelling in the arm due to disrupted lymphatic drainage. It's a significant concern and can be long-term.
- Infection: As with any surgery, there's a risk of infection at the incision site.
- Numbness: Damage to nerves in the armpit can lead to numbness or altered sensation in the arm or chest.
- Limited arm movement: Scar tissue formation can restrict arm movement.
What is Sentinel Lymph Node Biopsy (SLNB)?
Sentinel lymph node biopsy (SLNB) is a less invasive procedure compared to ALND. It involves identifying and removing only the first few lymph nodes that cancer cells are most likely to spread to. A special dye or radioactive tracer is injected near the tumor, allowing the surgeon to pinpoint these sentinel nodes. Only these nodes are removed and examined for cancer.
What are the advantages of SLNB over ALND?
SLNB offers several advantages over ALND:
- Less invasive: A smaller incision and less tissue removal lead to faster recovery times and reduced scarring.
- Lower risk of complications: The reduced invasiveness translates to a lower risk of lymphedema and other complications.
- Faster recovery: Patients typically experience quicker recovery and return to normal activities sooner.
Why might breast tissue be removed during these procedures?
It's important to clarify that during ALND and SLNB, the primary focus is on removing lymph nodes, not breast tissue itself. However, if during the procedure, the surgeon discovers any suspicious tissue adjacent to the lymph nodes, they might remove it for further examination. This is not a planned removal of breast tissue; it's a measure taken based on intraoperative findings. This additional tissue removal is performed to ensure complete removal of any cancerous cells that might have spread beyond the lymph nodes.
Is there a risk of breast tissue being mistakenly removed?
The risk of unintentionally removing healthy breast tissue during ALND or SLNB is low. Surgeons are highly trained to precisely identify and remove lymph nodes while preserving surrounding healthy tissue. However, like all surgical procedures, there is a small inherent risk.
What happens after the procedure?
After either ALND or SLNB, patients will need to follow post-operative care instructions meticulously. This includes managing pain, keeping the incision clean and dry, and monitoring for signs of infection or complications like lymphedema. Follow-up appointments with the surgeon and oncologist are vital for monitoring recovery and ensuring ongoing cancer treatment if needed.
How is lymphedema treated?
Lymphedema, a potential complication of ALND, can be managed with various therapies, including:
- Manual lymphatic drainage: A specialized massage technique that helps move fluid out of the swollen area.
- Compression therapy: Wearing compression garments to reduce swelling.
- Exercise: Specific exercises designed to improve lymphatic drainage.
- Complete Decongestive Therapy (CDT): A comprehensive approach combining manual lymphatic drainage, compression, exercise, and skin care.
This information is intended for general knowledge and should not be considered medical advice. Always consult with your healthcare provider for personalized guidance regarding your specific situation.
