Axillary Lymph Node Dissection (ALND)

Axillary Lymph Node Dissection (ALND) is a procedure in which anywhere from about 10 to 40 (though usually less than 20) lymph nodes are removed from the area under the armpit (axilla) and checked for cancer spread.

For most breast cancers, a level 1 and level 2 ALND is done if an ALND is needed (other types of non-breast cancers may require in addition a level 3 ALND).

Sometimes the ALND is done at the same time as other surgery for breast cancer and sometimes it is an operation that is done on its own.

ALND may be needed:

  • If a previous SLNB has shown 3 or more of the underarm lymph nodes have cancer cells
  • If swollen underarm or collarbone lymph nodes can be felt before surgery or seen on imaging tests and a biopsy shows cancer
  • If the cancer has grown large enough to extend outside the lymph node(s)
  • If the SLNB is positive for cancer cells after chemotherapy was given to shrink the tumor before surgery