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Lymph Node Involvement
Our bodies have a network of lymph nodes and lymph vessels that carry and remove fluid, similar to the way blood vessels circulate blood to all parts of the body. The lymph fluid has white blood cells, which help fight infection. With invasive breast cancer, tumor cells may spread through the lymph vessels. Therefore, during surgery for invasive breast cancer, the doctor usually removes some of the lymph nodes and vessels from the underarm (axilla) to see if the cancer has spread. If cancer cells are found in any of the lymph nodes, it is reported as positive. The report will indicate how many lymph nodes were removed and how many are positive (e.g., 0/11 is no positive nodes out of 11; 3/15 is three positive nodes out of 15 removed). In general, negative lymph node status is better than positive and a lower number of positive nodes is better than a higher number.
An axillary dissection is surgery in the armpit to remove lymph nodes (small glands that filter cellular fluids) to determine whether cancer has spread there and perhaps elsewhere in the body. The surgeon generally removes five to 30 nodes. The total number of cancerous lymph nodes is more important than the amount of cancer in any one node.
A sentinel lymph node biopsy removes only one to three lymph nodes. The sentinel node is the first lymph node(s) where cancer cells spread from a primary tumor. The surgeon injects a traceable substance near the tumor and checks the area to determine which nodes have taken up the substance. That node or nodes are then removed and examined for the presence of cancer cells.
If breast cancer cells are detected, the cancer is more likely to recur. Due to this increased risk, your doctor will probably recommend systemic therapy, which treats the whole body and includes chemotherapy and/or hormonal therapy.