If you have a sentinel lymph node (SLN) biopsy after a breast cancer diagnosis and the results show that cancer may be present in your lymph nodes, your surgeon may recommend an axillary lymph node dissection. During an axillary lymph node dissection, your surgeon will remove all or a group of lymph nodes in your axilla (armpit).
After your procedure, your lymph nodes will be tested for cancer. Your UPMC breast cancer care team will use this information to determine the stage of breast cancer you have and recommend a personalized treatment plan.
If you have a sentinel lymph node (SLN) biopsy after a breast cancer diagnosis and the results show that cancer may be present in your lymph nodes, your surgeon may recommend an axillary lymph node dissection. During an axillary lymph node dissection, your surgeon will remove all or a group of lymph nodes in your axilla (armpit).
After your procedure, your lymph nodes will be tested for cancer. Your UPMC breast cancer care team will use this information to determine the stage of breast cancer you have and recommend a personalized treatment plan.
Your lymphatic system — which carries white blood cells that fight infection — is a major pathway through which cancer cells can spread to other areas of your body. If breast cancer cells break through the duct or lobe and invade the surrounding breast tissue, they have the potential to travel to the lymph nodes under your arm.
Removing your lymph nodes during an axillary lymph node dissection and testing them for cancer cells can help your doctor determine if your breast cancer has spread to your lymph nodes or other parts of your body.
Yes, axillary lymph node dissection is considered a major surgery.
There are three levels of axillary lymph node dissection, including:
A traditional axillary lymph node dissection usually includes removal of the nodes in levels I and II from the "fat pad" under the arm.
You may need an axillary lymph node dissection if you receive a breast cancer diagnosis and a SLN biopsy shows that cancer may be present in your lymph nodes.
You may be a candidate for axillary lymph node dissection if your doctor suspects that your breast cancer may have spread to the lymph nodes under your arm.
Removing the lymph nodes in your underarm area can affect the way your body moves lymph fluid through your system, increasing your risk of developing lymphedema. Lymphedema causes swelling in your arm, which can lead to wounds and infections if left untreated.
Other complications may include:
You may have moderate to severe pain at your incision site in the first few days after your procedure, depending on the extent of your surgery. However, the discomfort should improve after a few weeks and be completely gone after six to eight weeks.
Many people also have shoulder stiffness and pain. Physical therapy and pain medication can help treat these symptoms.
To prepare for the procedure, you should:
On the day of your procedure, please bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
You may be discharged the same day as your surgery, or you may need to stay in the hospital overnight. Your doctor will let you know what to expect.
If you need to stay overnight, you should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You will also need to arrange for someone to drive you home after you are discharged.
Axillary lymph node dissection takes one to three hours, depending on the extent of the procedure.
When you arrive at the hospital, you will meet with your care team for final preparations.
You will receive an IV in your hand or arm. You will have general anesthesia to put you to sleep.
During your axillary lymph node dissection, your surgeon will:
After your procedure is complete, you will be monitored in the recovery area. If you are staying overnight in the hospital, you will be transferred to your room. If you are discharged the same day, you will be released from the hospital when your condition is stable.
Whether you stay overnight or are discharged the same day, you will need to arrange for someone to drive you home from the hospital.
Before you go home, your doctor will tell you:
Your doctor may also recommend that you see a lymphedema specialist, who can monitor your condition and help you reduce your risk of lymphedema after your procedure.
You should let your surgeon know if you have:
Most people can resume their normal activities and return to work four to six weeks after an axillary lymph node dissection. If your surgeon placed a surgical drain, it will be removed after about a week.
You may experience symptoms that should gradually improve over several weeks, including:
Your doctor will give you instructions on how to care for your incision, along with exercises to improve the range of motion in your arm and shoulder. Additionally, your doctor may refer you to a physical therapist to help improve your arm strength and a lymphedema specialist to monitor your condition and reduce your risk of developing lymphedema.
You will need to avoid lifting, pushing, or pulling for several weeks, and should attend all follow-up appointments.
Long-term effects of axillary lymph node dissection may include:
Your doctor will send the removed lymph nodes to the lab, where a pathologist will check them for signs of cancer. Based on the results, your doctor will develop a personalized treatment plan for you.
Axillary lymph node dissection test results may include:
When you choose UPMC for axillary lymph node dissection, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-09-18.
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