Lymph nodes are part of the body's lymphatic system. They transport fluid that provides the body's cells with oxygen and nutrients and removes waste from the body's tissues. Lymph nodes also contain immune system cells that monitor the fluid for substances like bacteria and viruses. They also help determine if breast cancer has begun to spread.

One of the earliest places cancers spread from a tumor to the rest of the body is through lymph nodes. The first nodes to which they spread are called sentinel nodes. To find out if a cancer has spread, your doctor may perform sentinel lymph node mapping and biopsy. Focusing solely on the sentinel nodes - typically one or two - is less invasive than removing all of the lymph nodes in an area and reduces the opportunity for side effects and harm.

SENTINEL-NODE BIOPSY - a small amount of radioactive material +/- blue dye are injected around the tumor, which then travels to the sentinel node(s) and helps us identify them. The node(s) are then removed and examined to see if they have cancer. If they do not contain cancer, it is unlikely that the other nodes under the arm have cancer. Usually this means that we will not need to remove any other lymph nodes. Having fewer lymph nodes removed results in a less painful recovery and lowers the likelihood that you will develop lymphedema and other problems caused by damage to lymph vessels and lymph nodes.

AXILLARY DISSECTION - removal of axillary (underarm) lymph nodes that show evidence of cancer. We generally remove between fifteen and thirty nodes during a traditional axillary dissection.

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