Possible side effects

Possible side effects: As with any operation, pain, swelling, bleeding, and infection are
possibilities.
The main possible long-term effect of removing axillary lymph nodes is lymphedema
(swelling) of the arm. Because any excess fluid in the arms normally travels back into the
bloodstream through the lymphatic system, removing the lymph nodes sometimes blocks
the drainage from the arm, causing this fluid to build up. This results in arm swelling.
Lymphedema develops in up to 30% of women who have a full ALND. It also occurs in
up to 3% of women who have a sentinel lymph node biopsy. It may be more common if
radiation is given after surgery. Sometimes the swelling lasts for only a few weeks and
then goes away. Other times, the swelling lasts a long time. Ways to help prevent or
reduce the effects of lymphedema are discussed in the section, "What happens after
treatment for breast cancer?" If your arm is swollen, tight, or painful after lymph node
surgery, be sure to tell someone on your cancer care team right away.
You may also have short- or long-term limitations in moving your arm and shoulder after
surgery. This is more common after an ALND than a SLNB. Your doctor may give you
exercises to ensure that you do not have permanent problems with movement (a frozen
shoulder). Numbness of the skin on the upper, inner arm is another common side effect
because the nerve that controls sensation here travels through the lymph node area.
Some women notice a rope-like structure that begins under the arm and can extend down
towards the elbow. This, sometimes called axillary web syndrome or lymphatic cording,
is more common after an ALND than SLNB. Symptoms may not appear for weeks or
even months after surgery. It can cause pain and limit movement of the arm and shoulder.
This often goes away without treatment, although some patients seem to find physical
therapy helpful.