What is axillary lymph node dissection for lung cancer?
Axillary lymph node dissection for lung cancer is surgery to remove the axillary lymph nodes (lymph nodes in the armpit). Lymph fluid from the skin of the arms, breast and other tissues drain into the axillary lymph nodes. This lymph fluid can also carry cancer cells into the axillary lymph nodes. As cancer progresses, you could feel a lump in your armpit as the nodes grow larger.
Although it is rare for primary lung cancer to spread to the axillary lymph nodes, it can occur, and the axillary lymph nodes should be monitored.
Why is an axillary lymph node dissection for lung cancer done?
An axillary lymph node dissection for lung cancer may be necessary in the following cases:
- Find out how many lymph nodes contain cancerous cells and how far the cancer has spread
- Remove lymph nodes that contain cancer
- Remove any lymph nodes that are likely to develop cancer in the future
- Determine stage of lung cancer
- Remove any remaining cancerous cells after chemotherapy or radiation therapy
What are the risks of axillary lymph node dissection for lung cancer?
Axillary lymph node dissection is an invasive surgery, and complications can be severe. Complications can arise years after the initial surgery and may include:
- Infection at incision site
- Pain
- Fever
- Inability to move the shoulder
- Swollen arm
- Collection of fluid under the arm
- Lymphedema
What to expect during axillary lymph node dissection for lung cancer?
An axillary lymph node dissection is performed under general anesthesia (you will be put to sleep). In many cases, you will have surgery to remove the primary lung tumor at the same time as the axillary lymph node dissection.
Your doctor will make an incision under your arm and will remove 10-40 lymph nodes. Your surgeon will then send the lymph nodes to be evaluated by a pathologist for evaluation. After the lung tumor and lymph nodes have been removed, your surgeon will drain any fluid or air that has been trapped in the cavity. Your doctor may insert a drainage bag that is left in place for a few weeks that helps remove any fluid that builds up in the affected space.
Recovery from axillary lymph node dissection for lung cancer
You will need to stay in the hospital for one to two days after surgery. Your doctor will give you strict discharge instructions that outline:
- How to take care of your wound
- Antibiotics to prevent infection at the incision site
- Pain medication (if necessary)
- Instructions on how to drain fluid bag
- When to follow up with your doctor
- Side effects and when to report serious ones
Results from an axillary lymph node dissection
A pathologist will evaluate each lymph node to determine if contains cancerous cells. If the lymph node does not have cancer cells, it is called a negative lymph node. If the lymph node does contain cancer cells, it is considered a positive lymph node.
The results the pathologist will send to your doctor will include:
- Stage of cancer you have
- Number of lymph nodes you had removed
- Number of lymph nodes that contain cancer cells
- Determination if cancer has grown through the outer capsule of the lymph node
Your Mercy Health doctor will review these results with you and discuss any further treatment or next steps.