Lymph Node Surgery Adelaide
Dr Samuel Rice – MBBS, FRACS
Breast Surgeon Adelaide
Learn more about lymph node surgery and Dr Rice’s approach to your medical care.
Lymph Nodes
What are Lymph Nodes?
Lymph nodes (also known as lymph glands), are part of the lymphatic system which are part of your body’s immune and circulatory systems.
Lymph nodes are small, bean-shaped structures that are found along the lymph vessels (note green structures in image).
They contain white blood cells (which fight infection), carry nutrients and also take away harmful substances such as bacteria, viruses, cell debris and abnormal cells such as cancer cells.
There are hundreds of lymph nodes found throughout your body, including your armpits, groin, neck, between your lungs and around your gut.
Your lymph nodes play an important role in the diagnosis and treatment of cancer.
Lymph Nodes & Breast Cancer
Lymph nodes located in and around the armpit, are where cancer cells from breast cancer usually spread to first.
Removing some of these lymph nodes may help Dr Rice check for cancer and its potential spread.
Lymph Node Surgery
Lymph Node Surgery or Lymphadenectomy is the surgical removal and dissection of lymph nodes and is an important part of cancer staging and treatment.
Analysing lymph nodes for signs of cancer can help Dr Rice determine if the cancer is spreading.
Lymph nodes are usually checked for cancer in two ways:
1. Sentinel lymph node biopsy – Whereby only a few lymph nodes are removed and analysed.
2. Axillary lymph node dissection – A larger number of lymph nodes are removed and analysed.
Lymph node surgery may be part of the main surgery to remove the breast cancer or done as a separate operation.
Sentinel Lymph Node Biopsy
What is a sentinel lymph node – A sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from a primary tumour. Sometimes, there can be more than one sentinel lymph node.
A negative result suggests that cancer has not yet spread to nearby lymph nodes or other organs.
A positive result indicates that cancer is present in the sentinel lymph node and that it may have spread to other nearby lymph nodes and other parts of the body.
During a sentinel lymph node biopsy, Dr Rice will identify and remove one or more of the sentinel lymph nodes from the armpit to see if there is any evidence of cancer or to investigate if the cancer has spread to other parts of the body.
Usually, if there is no cancer in these sentinel nodes it means the remaining axillary lymph nodes are not likely to contain cancer cells.
What happens during a Sentinel Node Biopsy – First, the sentinel lymph node (or nodes) must be located. To do so, Dr Rice injects a radioactive substance, a blue dye, or both near the tumour. He then uses a device to detect lymph nodes that contain the radioactive substance or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, Dr Rice makes a small incision in the overlying skin and removes the node. He then closes the incision area with stitches. Occasionally a drain is needed under the incision area, which usually then taken out the next day.
The sentinel node is then checked for the presence of cancer cells by a pathologist. If cancer is found, Dr Rice may remove additional lymph nodes, either during the same biopsy procedure or during a follow-up surgical procedure. A sentinel lymph node biopsy may be done on an outpatient basis or may require a short stay in the hospital.
A sentinel lymph node biopsy is usually done at the same time the primary tumour is removed. In some cases the procedure can also be done before or even after (depending on how much the lymphatic vessels have been disrupted) removal of the tumour.
Axillary Lymph Node Dissection
What are Axillary Lymph Nodes – The lymph nodes in the armpits are called axillary lymph nodes. The number of axillary lymph nodes vary from person to person (usually between 20 to 40).
After a breast cancer diagnosis, Dr Rice may check whether cancer cells have spread to the axillary lymph nodes. This can help confirm the diagnosis and staging of cancer.
Why undertake Axillary Lymph Node Dissection – An axillary lymph node dissection is done to:
- Check for cancer in the lymph nodes of the armpit
- Confirm how many lymph nodes contain cancer and how much cancer has spread to them
- Remove lymph nodes that contain cancer (or have a high chance that cancer may spread to them)
- Reduce the chance that the cancer will reoccur
- Remove cancer that is still in the lymph nodes after radiation therapy or chemotherapy
- Assist you medical team to plan further treatment
During Axillary Lymph Node Dissection – An axillary lymph node dissection is done under general anaesthetic in a hospital operating room.
Dr Rice makes a cut (incision) under the arm and may remove 10–40 lymph nodes which are then sent to a lab to be examined for signs of cancer. Because more lymph nodes are examined, Dr Rice may have conclusive evidence of whether the cancer has potentially spread around the body.
After removing the lymph nodes, Dr Rice places a small tube (drain) and closes the cut with stitches or staples. The drain is usually left in place for about 5 days. Dr Rice will cover all the information you need including pain relief, recovery timeline, wound care, potential side effects and follow up appointments.
Lymph Node Surgery – Potential risks and complications
All surgeries carry risks and potential complications. Breast surgery risks may include but not limited to:
| Potential Risk | Description | Chance of Occurring |
|---|---|---|
| Post-operative bleeding | This may occur round the surgical site. | Less than 5% |
| Wound infection | Wound infection is rare after surgery. If an infection does occur, consult nursing staff and Dr Rice for evaluation immediately. | Less than 5% |
| Need for Further Surgery | Further surgery may be needed in some cases depending on your circumstances and further test results. | 5% |
Lymph Node Surgery – After the operation
Dr Rice will see you soon after your surgery to ensure the operation and your recovery is going to plan.
After the procedure – After surgery, you’re moved to a recovery room where the health care team monitors your recovery from the surgery and the anesthesia. Once you’re fully conscious, you’ll be moved to a hospital ward room.
Some people may need to have a drain placed under the incision area – For a:
Sentinel Node Biopsy – Occasionally a drain is needed after sentinel node biopsy and may come out the next day.
Axillary Node Dissection – A drain is usually left in place for about 5 days.
After surgery, you may experience some pain near the surgical area and the neck. These symptoms are often short-term and may be due to irritation from the breathing tube that’s inserted into the windpipe during surgery, or nerve irritation caused by the surgery.
You’ll be able to eat and drink as usual after surgery. Depending on the type of surgery you had, you may be able to go home the day of your procedure or Dr Rice may recommend that you stay overnight in the hospital.
When you go home, you can usually return to your regular activities. Wait at least 10 days to two weeks before doing anything vigorous, such as heavy lifting or strenuous sports.
It may take up to a year or more for the scar from surgery to fade.
Dr Rice is a proud member of Breast Surgeons of Australia and New Zealand.
Lymph Node Surgery Adelaide
Dr Rice consults with patients from all over Adelaide in relation to Breast Surgery including Lymph Node Surgery and Ultrasound Guided Biopsy. Dr Rice is supported by a dedicated team who provide information and care in a sensitive and supportive manner to address the needs of patients attending the hospital and undertaking surgery and recovery. Dr Rice consults from three locations including Calvary North Adelaide Hospital, Calvary Central Districts Hospital and 480 Specialist Centre.