When breast cancer advances beyond Stage I, there may be lymph node involvement. Lymph node involvement means there's cancer in the lymph nodes. The lymph nodes are part of the lymphatic system, which also includes the spleen and bone marrow. The lymphatic system carries lymph fluid and helps transport excess liquid, fatty acids and immune system cells throughout the body. The lymph nodes are usually the first place that cancer spreads to, and lymph node involvement can make it more difficult to cure the cancer. There are three categories of lymph node involvement: microscopic, gross and extra-capsular extension.
Sentinel Lymph Node Dissection
Traditional breast cancer treatment involved a procedure called axillary lymph node detection. This procedure involved the removal of approximately 10 lymph nodes during a mastectomy or lumpectomy to check for the presence of cancer cells. This procedure had many potential side effects, including permanently limiting mobility in the arm on the side of the body with the affected lymph nodes.
Sentinel lymph node dissection has replaced axillary lymph node dissection as the procedure of choice for many women with smaller, less aggressive forms of breast cancer. Sentinel lymph node dissection involves removal of the lymph node closest to the breast, along with removal of the two lymph nodes nearest that lymph node. These three lymph nodes are most likely to be the first lymph nodes to which the cancer spreads. If there is no cancer present in these lymph nodes, it is likely that the cancer has not spread to any other lymph nodes.
If cancer is discovered in the lymph nodes during a sentinel lymph node dissection, then either an axillary dissection or radiation or both may be recommended.
Axillary Dissection
Axillary lymph nodes are the lymph nodes normally affected by breast cancer. They are located under the arm, by the pectoralis muscle. In an axillary dissection, two levels of axillary lymph nodes are usually removed: those at the lower end of the pectoralis minor muscle (level 1) and those under the pectoralis minor muscle (level 2). Between five and thirty lymph nodes are usually removed as part of the operation.
An axillary dissection may be done as part of a mastectomy (surgery to remove the breast) as part of a lumpectomy (surgery to remove part of the breast that has cancer in it) or as an independent surgical procedure.
Radiation
If cancer is present in lymph nodes, and/or if all the cancer can't be removed with an axillary dissection, radiation therapy may be prescribed. Radiation is often used in conjunction with chemotherapy and surgery, but it can be used alone as well. External beam radiation is the most common type of radiation used to treat lymph node involvement with breast cancer. This means a machine is used to point external rays of light at the lymph nodes that contain cancer cells in an attempt to kill the cancer cells in the lymph nodes.
Tags: lymph nodes, lymph node, breast cancer, node involvement, axillary dissection, lymph node, lymph node involvement
