What do underarm lymph nodes do? Why do they swell up? And how do you know if the swelling is simply an infection – or might be cancer?
You're taking a shower, soaping up. And suddenly, underneath your arm, your fingers detect a painful, tender lump – one that wasn't there yesterday. Your mind starts to race: "Do I need to worry about this? Could it be an infected lymph node, even though I haven't felt sick? Could it be… cancer?"
What is the lymphatic system?
Your body's lymphatic system, made up of a series of small vessels, carries a clear liquid – lymph – from your body tissues to the heart. In the heart, lymph joins blood and is pumped via arteries back to the tissues. This efficient system helps drain excess liquid from tissues, and transports infection-fighting white blood cells to where they're needed.
What are lymph nodes?
Scattered along these small lymphatic vessels are up to 700 lymph nodes. These small (think...
The lymph nodes reveal information about outlook and they help doctors determine the best types of treatment against the cancer. Your lymph nodes act as filters for your body's lymphatic drainage system. That's why the lymph nodes are likely to "catch" or filter out cancer cells that might be floating in the fluid that drains away from the cancerous area of the breast.
The surgeon will inject a blue dye and a radioactive substance (called a tracer) into the tumor or the skin over the tumor. The first lymph nodes that turn blue and pick up the tracer are called the sentinel (meaning "first") lymph nodes. The lymph node or nodes are then removed and sent to the pathologist, who looks to see if they contain any cancer cells. If no cancer cells are found, then no additional lymph node surgery is done.
If cancer cells are found in the nodes, then more underarm lymph nodes usually need to be removed. This is called an axillary (the armpit area) lymph node dissection (removal). There are thr...
There are three levels of axillary lymph nodes (the nodes in the underarm or "axilla" area):
Level I is the bottom level, below the lower edge of the pectoralis minor muscle.
Level II is lying underneath the pectoralis minor muscle.
Level III is above the pectoralis minor muscle.
A traditional axillary lymph node dissection usually removes nodes in levels I and II. For women with invasive breast cancer, this procedure accompanies a mastectomy. It may be done at the same time as, or after, a lumpectomy (through a separate incision).
Based on the doctor's physical exam and other indicators about the likelihood that cancer has spread to your lymph nodes, the surgeon will generally remove between five and thirty nodes during a traditional axillary dissection. The total number of lymph nodes "involved" (showing evidence of cancer) is more important than the extent of cancer in any one node.
Your doctor will let you know if any lymph nodes were involved (and if so, how many), as well ...
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