Lymph Nodes

All the descriptions of a tumor are of secondary importance compared with the axillary lymph node status. This determines if the lymph nodes under the arm on the side of the breast cancer contain cancer cells that have spread from the breast. Negative lymph nodes are better than positive lymph nodes. But "1 to 3" positive lymph nodes are better than "4 or more" positive lymph nodes. Fortunately, the majority of breast cancers are small and have not yet spread to the lymph nodes.

Sentinel Lymph Nodes Biopsy

Sentinel lymph node biopsy is a new technique where the surgeon can target the one (or possibly two or three) lymph nodes that are most likely to contain cancer cells if any at all are present. If the sentinel lymph node(s) do not contain tumor cells, no further lymph nodes are removed. This proven technique has advantages over standard lymph node surgery in that (1) there are fewer postoperative complications (arm swelling, tingling sensation, and arm discomfort, commonly referred to as lymphadema) and (2) the pathologist can then concentrate the examination by preparing extra microscopic slides and using additional testing to highlight small numbers of tumor cells. If the sentinel lymph node(s) contain tumor cells, the remainder of the lymph nodes are removed (full axillary dissection) because the total number of lymph nodes that contain tumor cells will determine the type of treatment needed.