NCCN Guidelines for Patients
Stages I and II Breast Cancer, Version 1.2014
Surgery/reconstruction Side effects of cancer surgery
dissection is more likely to find cancer, if present, than
a physical exam, imaging test, or a lymph node biopsy.
Axillary lymph node dissection is based on the results
of the lymph node biopsy or sentinel dissection. If
cancer is found by either method, you will likely have
a Level I and II axillary dissection. Under very specific
conditions an axillary dissection is not done if cancer
is found with sentinel dissection. An axillary dissection
is also recommended if the sentinel lymph node isn’t
found during the sentinel dissection. If no cancer is
found with a sentinel dissection, an axillary dissection
Lymph node dissections are often done at the time of
the breast surgery. During a lumpectomy, lymph nodes
are removed through a second surgical cut. During a
mastectomy, lymph nodes are removed through the
same cut used to remove the breast tumor.
However, neoadjuvant treatment may fully treat
cancer that has spread to the axillary lymph nodes.
If the cancer is fully treated, your doctors won’t know
that the cancer has spread if dissection is after
neoadjuvant treatment. Knowing if the cancer has
spread is important for treatment planning. Thus, a
sentinel lymph node dissection may be done before
neoadjuvant treatment. After neoadjuvant treatment,
which is discussed in Part 4, you may have an axillary
lymph node dissection at the time of the breast
Side effects of cancer surgery
Unhealthy and unpleasant outcomes
Side effects are unhealthy or unpleasant physical
or emotional responses to treatment. Common side
effects of any surgery are pain, swelling, and scars.
Pain and swelling often fade away in the weeks
After breast surgery, you may also have a loss of
feeling where you had the surgery. A total mastectomy
may also cause stiffness, severe tiredness despite
sleep, and uncomfortable crawly sensations as your
nerves heal. If you receive general anesthesia, it may
cause a sore throat, nausea with vomiting, confusion,
muscle aches, and itching.
Side effects are more common and severe with
axillary lymph node dissection than sentinel lymph
node dissection. Lymphedema is the most serious
of these side effects and may be permanent.
Lymphedema is swelling due to buildup of lymph. It
occurs in the arms after node removal. Most women
find lymphedema bothersome but not disabling. There
is no way to know who will have it or when it will
occur. It can happen just after surgery or months to
Not all the side effects of surgery are listed here.
Please ask your treatment team for a complete list.
If a side effect bothers you, tell your treatment team.
There may be ways to help you feel better.