Based on the doctor’s physical exam and other information, the surgeon will generally remove between five and thirty nodes during a traditional axillary dissection.
There are three levels of axillary lymph nodes (the nodes in the underarm or “axilla” area):
Level I
Level II
Level III
Generally Level I and II are removed
Surgery takes about an hour. The process of being admitted and prepared for surgery will vary from place to place. The amount of time you spend in the recovery room, waking up and getting to the point that you're ready to go home, will vary from woman to woman.
Where will the incision be?
The incision is a 2–3-inch incision in the skin crease under your arm.
Most commonly, the lower two levels of the three levels of axillary nodes will be removed. Occasionally, she will take one or two nodes from the top level, as an extra precaution. If you have a modified radical mastectomy, the lymph node dissection usually occurs in the same operation. If you have a lumpectomy, the lymph node dissection may occur at the same time or in a later operation. Once she removes the nodes, a pathologist will examine them carefully for signs of cancer. It may take days before the pathology report is available.
Lost or decreased sensation in the back of the arm or armpit. Sometimes the nerve supplying sensation to the back of the arm and armpit is cut, stretched, or damaged during surgery. This loss of sensation may be temporary, but for some women, it may persist.
Tingling, numbness, stiffness, weakness, or lymphedema (swelling of the arm). It's important not to let your arm become weak and stiff as a result of discomfort and limited range of motion (mobility) after surgery.
Physical therapy and exercise can help restore your arm movement and strength. Inflammation of the arm veins as they pass through the armpit region. This inflammation can show up several days after surgery, and usually responds to treatment with ice and aspirin within several days
