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Axillary Lymph Node Dissection
Axillary Lymph Node Dissection (ALND) involves removal of all of a patient’s lymph nodes from under their arm.  This procedure is usually performed in women with locally advanced breast cancer, clinical or radiographically apparent lymph node disease at presentation, in patients who can not undergo a sentinel lymph node biopsy and in those who have positive lymph nodes on sentinel lymph node biopsy.  However this last indication is being brought under some question based on new data released from the ACOSOG Z11 trial. 

ALND is an effective staging procedure as the status of a patient’s lymph nodes is an important factor in predicting long term survival and need for chemotherapy. 

The rate of complications is slightly higher than for sentinel lymph node biopsy and can include numbness, decreased range of motion of the affected arm, seroma or fluid collection, infection, and lymphedema. 

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