The axillary lymph nodes are generally the first place where breast cancer spreads. These lymph nodes, which are located in the armpit, are always checked to determine whether the cancer has spread outside the breast. The lymph node biopsy procedure is performed by our top breast cancer surgeons.

Instead of removing all the axillary lymph nodes at surgery as was done in the past, we now minimize the surgery by checking the first draining lymph node of the cancer or “sentinel” lymph node.

A blue dye is given by the breast surgeon at the start of surgery to enable identification of the sentinel lymph node. A radioactive solution may also be injected by radiology prior to surgery to further assist the identification process. The solution is taken up by the lymphatic system and delivered to a single or a few axillary lymph nodes.

Lymph Node Biopsy Surgery Video


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At the time of surgery, a small incision is made in the armpit (in a cosmetically favorable place, using a natural crease), and the sentinel lymph node is identified. It is then gently removed and sent to pathology. If the sentinel lymph node is negative for cancer, no further nodes are removed. If the result is positive, the surgeon will then remove the other involved nodes to render the patient cancer-free. If a mastectomy patient has more than 3 positive lymph nodes, radiation is generally recommended in addition to chemotherapy. Understanding exactly which nodes are involved with the tumor is critical to a successful lymph node biopsy. Treatment decisions will be based on this information.

Breast preserving surgery, called lumpectomy, is done when possible unless the patient decides to have a complete mastectomy. In all breast preserving surgery, radiation is recommended. If the sentinel lymph node biopsy is positive for cancer, chemotherapy will be included in the treatment. Call our breast center today to find out more about this procedure.

“Dr Cassileth is not only an incredibly talented surgeon, she is also an angel. She helped me through my breast cancer journey, and I came out looking beautiful! Her one step mastectomy was life changing for me. Her facility is top notch, and her staff is amazing. I beat breast cancer, and thanks to Dr Cassileth, I looked great doing it!!” – Victoria L


Bedford Breast Center Serving Beverly Hills, Santa Monica and the greater Los Angeles areas.