Lymph Nodes in the Breast

Lymph nodes are small glands located throughout the body that help filter the lymph. They play an important role in immunity. The lymph is a clear fluid that circulates the lymphatic system, allowing the body to get rid of germs and waste products. When an infection occurs in the body, a signal occurs as chemical changes occur. The lymphatic system detects the changes and fights the infection.

Are there lymph nodes in the breast?

There are no lymph nodes in the breast, but there are lymph nodes located close to the breast. A network of lymph nodes close to the breast is called the sentinel lymph nodes. Another set of lymph nodes close to the breast is the axillary lymph nodes which are located under the armpit. They are located in the armpit and vary in number between 20 – 30 among individuals. They are the first site cancerous cells from the breast tissue invade. 

Why is the lymph node important in breast cancer?

Examining the axillary lymph aids diagnosis. A doctor checks the lymph nodes to know if cancer has invaded them. This step also helps in identifying the stage of breast cancer.

A diagnostic method used to check the axillary nodes for cancer is called sentinel node biopsy. This procedure involves injecting the breast with a tracer (a radioactive substance) or a blue dye. They detect the nodes to be removed by the doctor. The node removed is sent to the laboratory to check for the presence of cancer cells. The presence or absence of cancer cells determines the next line of action.

• If cancer cells are present, more nodes will be removed in a process called axillary dissection.
• If cancer cells are absent, then no more nodes will be removed because it is an indication that there are no cancer cells in the other nodes.

What causes swollen lymph nodes in the breast?

Causes of swollen lymph nodes in the breast include:

• bacterial, fungal, parasitic and viral infections,
• underlying health conditions such as lymphoma, etc.

How does cancer breast to the axillary lymph nodes?

Cancer gradually spreads from its origin to other parts of the body when cancer occurs. It can spread as the original or primary tumor splits and migrates to other sites in the body. When cancer spreads, it does so by travelling through the lymphatic system. This may result in the growth of cancerous cells in the lymph nodes, especially those closest to the breast.

As breast cancer spreads, it first invades the axillary lymph nodes, which are close to the breast, before getting to other lymph nodes. This could mean the cancer is now in stage 2 because it has spread from the primary tumor site.

A mastectomy is a recommended treatment for breast cancer. It usually involves surgically removing some or all of the axillary lymph nodes by cutting one or both breasts. But there are adverse effects to removing lymph nodes. Their removal could cause a condition called lymphedema, which leads to lymphatic fluid building up. There is persistent and long-term swelling of the arm or some other parts, such as the hand, breast, back, etc. Lymphedema causes numbness and reduced mobility of the region from which the lymph nodes were removed can occur. 

The invasion of the axillary nodes by cancer from the breast tissue results in the following:

• swelling of the lymph nodes in the armpit
• swelling of the arm
• lump in the breast

The above are symptoms of breast cancer. Thus, such individuals should seek help from a healthcare practitioner immediately.

Treatment Options

Recommendations and treatment provided by the doctor will depend on the following:

• type of breast cancer (the hormone and HER2 receptor status of the cancerous cells in the breast tissue),
• the stage of cancer,
• genetics, and
• tumor grade. 

An aggressive form of treatment is employed when cancer spreads to the lymph nodes. This is because when cancer gets to the lymphatic system, it has more potential to invade other parts of the body.

The treatment options for breast cancer 

• Chemotherapy
• Hormone therapy
• Immunotherapy
• Lymph node dissection – This includes:

1. regional lymph node dissection (removal of some lymph nodes near the site of the tumor), and 
2. radical lymph node dissection (removal of all lymph nodes close to the tumor site).

• Radiation therapy – types are internal radiation and external beam radiation
• Surgery – lumpectomy (removal of the breast tumor) and mastectomy (removal of the entire breast that is affected)

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