Lymph nodes play a key role in filtering out bacteria and other harmful substances while also exposing them to infection-fighting white blood cells and triggering an immune response. The more lymph nodes you have removed, the greater the disruption to your immune system.
Lymph nodes drain fluid from your arms and legs. If the surgeon removes the lymph nodes, fluid can build up and cause swelling in your arms or legs. This is called lymphoedema. Your doctor and nurses will tell you how you can reduce your chance of getting lymphoedema.
A team including University of Georgia researchers has for the first time documented the regrowth of surgically removed pathways in the lymphatic system, a network of vessels designed to pump away inflammatory fluids and defend the body against infection.
Effects of removing lymph nodes. When lymph nodes are removed, it can leave the affected area without a way to drain off the lymph fluid. Many of the lymph vessels now run into a dead end where the node used to be, and fluid can back up. This is called lymphedema, which can become a life-long problem.
Sometimes, removing lymph nodes can make it hard for your lymphatic system to drain properly. If this happens, lymphatic fluid can build up in the area where the lymph nodes were removed. This extra fluid causes swelling called lymphedema.
More extensive lymph node removal, being treated on the non-dominant side, receiving radiation therapy and lower physical activity levels at 6 months was associated with higher body weights post-breast cancer (group differences >3 kg; all p < 0.05).
Avoid strenuous activities, such as biking, jogging, weightlifting, or aerobic exercise, until your doctor says it is okay. This includes housework, especially if you have to use your affected arm. You will probably be able to do your normal activities in 3 to 6 weeks.
Side effects of lymph node surgery. After lymph node surgery, pain, swelling, bleeding, blood clots, and infection are possible.
Also, some people can develop lymphedema even when lymph nodes are not removed if the lymphatic system in the skin is injured from extensive surgery or from radiation treatments.
Removal of the lymph nodes enables doctors to determine if a cancer has begun to metastasize. A lymphadenectomy may also prevent further spread of abnormal cells.
About Lymph Node Transplant Surgery
During your surgery, a piece of tissue with lymph nodes and lymphatic vessels and the small blood vessels that carry blood to the tissue are taken from one place in your body and moved to another place in your body. The piece of tissue is also called a flap or donor tissue.
If you have had lymph nodes removed, there is a risk of developing swelling later on. This swelling is called lymphoedema (limf-o-dee-ma). The lymph nodes are part of your body's drainage system. Removing them can affect the natural circulation and drainage of tissue fluid in this area.
The surgeon makes a small cut in your armpit to remove the lymph nodes. Generally, they remove between 10 and 15 lymph nodes.
After controlling for tumor size, histology, type of surgery, and adjuvant therapies, the investigators found that removal of more than five lymph nodes and presence of lymph node metastases were independent predictors of developing lymphedema.
Though the most intuitively obvious risk factor for lymphedema is the number of nodes removed, the relationship between the number of lymph nodes removed and the risk of lymphedema remains unresolved. Several retrospective studies have shown that the number of nodes removed and the risk of lymphedema do not correlate.
The extent of axillary surgery and the number of dissected LNs also appear to have a direct correlation with the risk of lymphedema. In previous studies, the estimated incidences of lymphedema were 19.3%–24.6% in patients who underwent ALND and 2.2%–8.3% in patients who underwent sentinel lymph node biopsy (SLNB).
Removing all the lymph nodes
This is called an axillary lymph node dissection (ALND) or clearance. An ALND is usually done when there are cancer cells in the fine needle aspiration (FNA) or biopsy of the lymph nodes. There is an increased risk of developing swelling of the arm called lymphoedema after having an ALND.
Risks of axillary lymph node dissection
Sometimes the nerve supplying sensation to the back of the arm and armpit is cut, stretched, or damaged during surgery. This loss of sensation may be temporary, but for some women it may persist. Tingling, numbness, stiffness, weakness, or lymphedema (swelling of the arm).
Two studies suggest that regional lymph node radiation after surgery to remove early-stage breast cancer reduces the risk of the cancer coming back (recurrence) but doesn't improve overall survival. Overall survival is how long women live, with or without the cancer coming back.
Recent reports suggest that the lymphatic role in lipid transport is an active and intricate process, and that when lymphatic function is compromised, there are systemic consequences to lipid metabolism and transport.
The resulting mixture of lymphatic fluid and fats – a milky-white substance known as 'chyle' – is carried through the lymphatic network and into the largest of the lymphatic vessels – the thoracic duct and thenceforth directly into the heart. It is only at this point that the fats we have eaten enter the bloodstream.
Should I exercise after my lymph node surgery? Yes. For most people, aerobic exercise, like walking, and strength training (lifting weights) is safe and recommended. Exercising can help with treatment side effects and joint stiffness.
Some foods can exacerbate lymphedema symptoms because of the way they are processed and the additives or high salt content they contain. These foods include added sugars — specifically fructose — refined grains, chemically modified fats and most animal and dairy products.
Physical activity encourages fluid to drain into the lymphatic system in the abdomen. Walking, swimming, yoga, pilates and Tai chi all might help to encourage the lymph to move. Pelvic floor exercises may also help.