Removal of lymph nodes from the axilla (underarm) gives information about whether or not breast cancer cells have spread outside the breast.

About this procedure

The state of the lymph nodes is an important indicator of prognosis because there is a direct relationship between the number of lymph nodes involved with cancer cells and the risk of the breast cancer recurring. Adjuvant therapy can be tailored to each woman on this basis. More and better options for treatment, preservation and reconstruction of the breast are now available for women diagnosed with breast cancer. Understanding what is available will empower women to play an active role in their care.

Who is it suitable for?

Those with a diagnosis of an invasive breast cancer or widespread DCIS (ductal carcinoma-in-situ).

What is involved?

There are different procedures for the removal of axillary lymph nodes (glands) including sentinel node biopsy, axillary sampling and axillary clearance (levels 1-3). They depend on the number of nodes removed and how the nodes are identified for removal. Surgery is done under a general anaesthetic as a day case or with an overnight stay in hospital.

Frequently asked questions

How do I know if this procedure is right for me?

It is important to discuss the operation with your surgeon. The aim of surgery is to obtain information about whether your cancer has spread beyond the breast into the lymph nodes, how many nodes (if any) that contain tumour and to remove the tumour. This information will guide further the need for further therapy (surgery, chemotherapy, radiotherapy).

How long does the procedure take?

From one hour.

How much does this procedure cost?

This depends on the complexity of the operation and length of stay in hospital. You will receive a cost breakdown before you book the operation.

Are there any potential side effects?

With any surgical procedure, there is a potential for unwanted effects. It is essential for you to minimize any risk factors (stop smoking, avoid blood thinning medications, stop the oral contraceptive pill, discuss other medications or supplements) when planning surgery.

Potential unwanted effects include: infection, bleeding, haematoma, seroma, altered sensation, lymphoedema(swelling of the arm), unsightly scars, delayed wound healing. In general, the smaller the number of nodes removed, the less likely is the chance of lymphoedema that may occur from months to years after the operation or radiotherapy.

It is important to discuss the operation with your surgeon. The aim of surgery is to obtain clear excision margins for complete tumour removal in order to reduce the risk of the cancer recurring, to determine if the cancer has spread beyond the breast and to guide further treatment. The best outcome is achieved when you and your surgeon agree that the chosen operation will achieve your goals and expectations, and that you understand and have carefully considered the potential benefit from the procedure against the possible unwanted effects and risks from it.

Find out more

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Related Procedures

Breast Conservation

If the tumour is small in relation to your breast, breast conserving surgery (Wide Local Excision, Lumpectomy or Quadrantectomy) may be possible.

Breast Removal

If the tumour is large in relation to your breast, breast removal surgery (otherwise known as a Mastectomy) may be required.

Breast Reconstruction

Various methods are available to reconstruct a breast using the woman’s own tissue or a prosthesis or a combination of these.


Based in London, Dr Lewis is a highly respected surgeon, with over 30 years experience in helping women feel good about their bodies.

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