✦ Axillary Lymph Node Dissection (ALND)

Axillary Lymph Node Dissection (ALND)

Q: What is the risk of lymphoedema?

Lymphoedema occurs in 15–25% of patients after ALND, higher if radiotherapy is added. Risk is reduced by protecting the arm, avoiding injury and infection, and early physiotherapy. Compression garments help manage it if it develops.

Q: How long does the drain stay?

The drain usually stays 7–14 days, until daily output drops below 30 ml. Patients can be discharged with the drain and return to clinic for removal. Drain care instructions and nursing support are provided.

Q: Will my arm movement be affected?

Temporary shoulder stiffness and discomfort are common. Structured physiotherapy starting within days of surgery usually restores full range of motion within 4–6 weeks. Intercostobrachial numbness is frequent but usually tolerable.

Q: Is ALND always needed after a positive SLNB?

No — modern evidence (Z0011, AMAROS) means many patients with limited sentinel node positivity can avoid ALND, receiving axillary radiotherapy instead. Decisions are individualised through multidisciplinary discussion.

Complete removal of the lymph nodes in the armpit, for patients with proven nodal disease requiring formal axillary clearance.

60–120 min PROCEDURE

2–3 Days HOSPITAL STAY

>95% SUCCESS RATE

3–4 Weeks RECOVERY

What is Axillary Lymph Node Dissection (ALND)?

Axillary Lymph Node Dissection (ALND) is the surgical removal of the lymph nodes in the axilla (armpit), typically levels I and II, for patients with proven axillary nodal disease from breast cancer. It provides definitive local control of nodal disease and accurate staging information. Dr. Abhishek performs ALND at Lux Hospitals with meticulous technique to preserve key structures — the thoracodorsal, long thoracic, and intercostobrachial nerves — reducing the risk of shoulder dysfunction and chronic neuropathic pain.

How the Procedure Works

Anaesthesia & Positioning

General anaesthesia is given; the arm is positioned on an arm board to expose the axilla.

Axillary Incision

A curved incision along the axillary skin crease gives access to the lymph node compartments.

Nerve Identification

The thoracodorsal, long thoracic, and intercostobrachial nerves are identified and preserved.

Level I & II Dissection

All level I (lateral to pectoralis minor) and level II (behind pectoralis minor) nodes are removed en bloc.

Drain & Closure

A suction drain is placed to prevent seroma; the skin is closed cosmetically in layers.

Outcomes

60–120 minDURATION

2–3 DaysHOSPITAL STAY

>95%SUCCESS RATE

Who Needs This Treatment?

→Definitive local control for axillary nodal disease
→Accurate staging guiding systemic therapy decisions
→Important nerves preserved with meticulous technique
→Reduces risk of axillary recurrence in node-positive disease
→Provides complete pathological assessment of nodal burden
→Still the standard of care for specific clinical scenarios

Axillary dissection is older surgery but it still has a role — for the right patient with proven nodal disease, it delivers local control no other option can match. The key is preserving every nerve that can be preserved.

— Dr. Abhishek Katha, Consultant General & Advanced Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

What is the risk of lymphoedema?+

How long does the drain stay?+

Will my arm movement be affected?+

Is ALND always needed after a positive SLNB?+

Not sure which treatment is right for you?

Book a consultation with Dr. Abhishek Katha and get a personalised treatment plan.

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