Possible Side Effects from Lymph Node Surgery: Sentinel Lymph Node Biopsy (SLNB) and Axillary Lymph Node Dissection (ALND)
Any surgery, including lymph node surgery) has a risk of bleeding and infection. Lymph node surgery also has the risk of a seroma formation (fluid collection at the surgical site). Many seromas resolve on their own. Some can be drained in the clinic or by radiology.
A possible long-term effect of lymph node surgery is swelling in the arm called lymphedema. Because any excess fluid in the arms normally travels back into the bloodstream through the lymphatic system, removing the lymph nodes sometimes blocks drainage from the arm, causing this fluid to build up.
Lymphedema is less common after a sentinel lymph node biopsy (SLNB) than an axillary lymph node dissection (ALND). The risk of clinically significant lymphedema is thought to be in the range of 2%-5% in women who have a SLNB and around 20% to25% in women who have a ALND. It may be more common if radiation is given after surgery or in women who are obese or have diabetes. Sometimes the swelling lasts for only a few weeks and then goes away. But in some women, it lasts a long time. If you are high risk of lymphedema after SLNB or have an ALND, you will be referred to a specialized physical therapist after surgery.
Range of Motion
You might also have limited movement in your arm and shoulder after surgery. This is more common after ALND than SLNB. Your doctor may advise exercises to help keep you from having permanent problems (a frozen shoulder) and refer you to a specialized physical therapist.
Some women notice a rope-like structure that begins under the arm and can extend down toward the elbow. This is sometimes called axillary web syndrome or lymphatic cording. It is more common after 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 women find physical therapy helpful.
Numbness of the skin on the upper, inner arm is a common side effect because the nerve that controls sensation here travels through the lymph node area. Sometimes the numbness resolves over time and sometimes is permanent.