The sentinel node biopsy and the frozen section method allow the doctor to decide whether more lymph nodes need to be removed. If cancer cells are found in sentinel node(s), then axillary nodes will be removed; if no cancer is found in the sentinel node(s), axillary nodes will be left alone. The more lymph nodes are removed, the higher the risk of lymphedema (permanent swelling of the arm) and numbness.
 
Types of Axillary Lymph Node Dissections
There are two types of axillary lymph node dissections:

1. Axillary lymph node dissection is the traditional method of removing the nodes below the lower edge and underneath the pectoralis minor muscle. For patients with invasive breast cancer, this procedure is done along with a mastectomy. The doctor will likely remove 10 to 50 nodes. This will also prevent cancer from metastasizing to the lymph nodes, if it hasn’t already. The total number of lymph nodes showing evidence of cancer is more important than the extent of cancer in any one node.
2. Sentinel lymph node biopsy is an alternative to the traditional dissection. It is not appropriate for everyone and in many cases, more surgery may still be necessary. In this type of procedure, instead of removing 10 or more lymph nodes and analyzing all of them to look for cancer, the doctor will remove only the one node that is most likely to have it, which is the sentinel lymph node—the first node that filters fluid draining away from the area of the breast that contained cancer. If this node is clean, chances are the other nodes have not been affected. The doctor will, in reality, remove a cluster of two or three nodes, including the sentinel node and those closest to it. This procedure may allow the doctor to assess overall lymph node status in women who have relatively small breast cancers and those whose lymph nodes are normal before surgery.

• Pain at the surgical site, which can be managed with prescribed medication.
• Infection, inflammation, swelling, redness, pain, and/or seeping of fluid.
• Slow healing of the wound, lack of circulation to the wound.
• Tightness in the chest on the side of the affected arm; weakness and numbness in the arm due to impact to nerves. (This symptom may be temporary or permanent.)
• Swelling of the arm (lymphedema), which is more likely the more lymph nodes are removed.

The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
 
What if the procedure is not performed?
Please discuss specific risks of not having the procedure done with your doctor.
 

Fine needle aspiration just for diagnosis in case with palpable lymph node.