Lymph nodes under the arm

If breast cancer spreads, it usually spreads first to the nearby lymph nodes.

If you have breast cancer, you will usually have an ultrasound scan under your arm (axilla) before surgery to see if the lymph nodes there look normal. If your doctor thinks some of the lymph glands look abnormal, they may want to take a biopsy, or a 'fine needle aspiration'.

The doctor uses the ultrasound scanner to guide a needle into the suspicious lymph nodes and takes out some fluid and cells. This is then examined for cancer cells in the lab.

At surgery, your doctor will either remove 4 or so lymph nodes from under your arm during your breast cancer surgery (axillary node sampling, ANS). These nodes are then examined in the lab to see whether they contain cancer cells.

Or, if cancer cells are found in the lymph nodes, your surgeon will suggest removing all, or most, of the remaining nodes from under your arm, during your initial operation or at a later operation. This is called 'axillary clearance' (ANC) or 'axillary lymph node dissection (ALND)'.