How does lymphatic flow differ after axillary lymph node dissection versus sentinel lymph node biopsy in breast cancer patients. What are the key findings of lymphoscintigraphy studies comparing these surgical approaches. Which technique shows better preservation of lymphatic drainage patterns.

Understanding Lymphatic Flow After Breast Cancer Surgery

Breast cancer surgery often involves manipulation of the axillary lymph nodes, which can impact lymphatic drainage in the arm. This study aimed to compare lymphatic flow patterns after two common surgical approaches:

• Axillary lymph node dissection (ALND)
• Sentinel lymph node biopsy (SLNB)

Researchers used lymphoscintigraphy (LS) to visualize and assess lymphatic drainage in the upper limb following these procedures. The goal was to better understand how each surgical technique affects arm lymphatics and identify any differences in drainage patterns.

Study Design and Methodology

This cross-sectional study involved 39 women who had undergone unilateral breast cancer surgery with either ALND or SLNB. Key aspects of the methodology included:

• Participants: Women over 18 years old
• Imaging technique: Lymphoscintigraphy
• Comparison: ALND group vs. SLNB group
• Analysis: Lymphatic flow area and lymph node identification

The researchers analyzed LS images acquired in three phases:

1. Immediate dynamic images
2. Immediate static images
3. Delayed scan images

They assessed the extent of lymphatic flow in the upper limb and identified the location and number of visualized lymph nodes in each group. Statistical analysis was performed with a significance level of 5%.

Key Findings: Lymphatic Flow Patterns

The study revealed significant differences in lymphatic drainage patterns between the ALND and SLNB groups:

ALND Group Observations

• More frequent visualization of lymphatic flow and/or lymph nodes in the arm and axilla (p=0.01)
• Higher incidence of extra-axillary lymph node identification (p<0.01)
• More common visualization of cubital lymph nodes in immediate dynamic images (p=0.004)
• Exclusive identification of deltopectoral lymph nodes (though not statistically significant)

SLNB Group Observations

• More frequent identification of axillary lymph nodes in delayed scan images (p<0.01)

Interestingly, there was no significant difference in the total number of lymph nodes identified between the two groups. However, the distribution and timing of lymph node visualization differed notably.

Implications for Lymphatic Function

These findings suggest that ALND may lead to more extensive alterations in arm lymphatic drainage compared to SLNB. Why might this be the case? ALND involves a more extensive removal of lymph nodes and surrounding tissue, potentially disrupting normal lymphatic pathways. This could explain the increased visualization of alternative drainage routes, such as through cubital and extra-axillary lymph nodes.

SLNB, being a less invasive procedure, appears to better preserve the natural lymphatic drainage patterns. The more frequent visualization of axillary lymph nodes in delayed images suggests that primary lymphatic pathways remain largely intact after SLNB.

Clinical Relevance and Patient Implications

Understanding these differences in lymphatic flow patterns has important implications for breast cancer patients:

• Risk assessment: Patients undergoing ALND may be at higher risk for lymphedema and other lymphatic complications
• Follow-up care: Tailored monitoring and management strategies based on the surgical approach
• Patient education: Informing patients about potential changes in lymphatic function
• Rehabilitation planning: Developing targeted interventions to support lymphatic health

Healthcare providers can use this information to guide decision-making and improve post-surgical care for breast cancer patients.

Advancements in Lymphatic Imaging Techniques

Lymphoscintigraphy has proven to be a valuable tool for assessing lymphatic function after breast cancer surgery. How does this imaging modality work?

LS involves injecting a radioactive tracer into the tissue and tracking its movement through the lymphatic system. This allows for real-time visualization of lymph flow and node identification. The three-phase acquisition used in this study (immediate dynamic, immediate static, and delayed images) provides a comprehensive view of lymphatic drainage patterns.

Other advanced imaging techniques that may complement LS in future research include:

• Near-infrared fluorescence imaging
• Magnetic resonance lymphangiography
• Hybrid SPECT/CT lymphoscintigraphy

These modalities may offer additional insights into lymphatic function and anatomy, further enhancing our understanding of post-surgical changes.

Future Directions in Lymphatic Research

While this study provides valuable insights, several areas warrant further investigation:

Long-term Follow-up

How do lymphatic drainage patterns evolve over time after surgery? Longitudinal studies could help elucidate the dynamic nature of lymphatic remodeling and adaptation.

Correlation with Clinical Outcomes

Do the observed differences in lymphatic flow patterns translate to meaningful clinical differences? Future research should explore the relationship between imaging findings and patient-reported outcomes, such as arm swelling, pain, or functional limitations.

Preventive Strategies

Can early interventions based on lymphoscintigraphy findings help mitigate the risk of lymphatic complications? Investigating targeted therapies or exercises to support lymphatic function could lead to improved patient care.

Personalized Approach

Are there individual patient factors that influence post-surgical lymphatic drainage? Exploring genetic, anatomical, or lifestyle variables may help predict which patients are most likely to experience lymphatic changes after surgery.

Evolving Surgical Techniques and Lymphatic Preservation

As breast cancer surgery continues to advance, new techniques aim to minimize lymphatic disruption while maintaining oncologic safety. Some emerging approaches include:

• Axillary reverse mapping: Identifying and preserving arm lymphatics during ALND
• Targeted axillary dissection: Removing specific nodes identified as positive, sparing others
• Lymphatic microsurgical preventive healing approach: Immediate lymphatic reconstruction during ALND

Future studies comparing lymphatic outcomes with these newer techniques to traditional ALND and SLNB could further refine surgical decision-making and improve long-term quality of life for breast cancer survivors.

In conclusion, this lymphoscintigraphy study highlights important differences in arm lymphatic drainage following ALND versus SLNB. The findings underscore the need for individualized post-surgical care and ongoing research to optimize lymphatic health in breast cancer patients. As our understanding of lymphatic physiology and imaging techniques continues to evolve, we can look forward to more targeted and effective strategies for preserving lymphatic function after breast cancer treatment.

Arm lymphoscintigraphy after axillary lymph node dissection or sentinel lymph node biopsy in breast cancer

. 2017 Mar 6;10:1451-1457.

doi: 10.2147/OTT.S117830.

eCollection 2017.

Almir José Sarri 
¹
, Rogério Dias 
²
, Carla Elaine Laurienzo 
¹
, Mônica Carboni Pereira Gonçalves 
³
, Daniel Spadoto Dias 
²
, Sonia Marta Moriguchi 
⁴

Affiliations

Affiliations

• ¹ Department of Physical Therapy, Barretos Cancer Hospital, Barretos.
• ² Department of Obstetrics, Gynaecology and Mastology, Botucatu Medical School, São Paulo State University – UNESP, Botucatu.
• ³ Department of Nuclear Medicine, Barretos Cancer Hospital, Barretos.
• ⁴ Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University – UNESP, Botucatu, São Paulo, Brazil.

• PMID:

  28331338

• PMCID:

  PMC5348076

• DOI:

  10.2147/OTT.S117830

Free PMC article

Almir José Sarri et al.

Onco Targets Ther.

2017.

Free PMC article

. 2017 Mar 6;10:1451-1457.

doi: 10.2147/OTT.S117830.

eCollection 2017.

Authors

Almir José Sarri 
¹
, Rogério Dias 
²
, Carla Elaine Laurienzo 
¹
, Mônica Carboni Pereira Gonçalves 
³
, Daniel Spadoto Dias 
²
, Sonia Marta Moriguchi 
⁴

Affiliations

• ¹ Department of Physical Therapy, Barretos Cancer Hospital, Barretos.
• ² Department of Obstetrics, Gynaecology and Mastology, Botucatu Medical School, São Paulo State University – UNESP, Botucatu.
• ³ Department of Nuclear Medicine, Barretos Cancer Hospital, Barretos.
• ⁴ Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University – UNESP, Botucatu, São Paulo, Brazil.

• PMID:

  28331338

• PMCID:

  PMC5348076

• DOI:

  10.2147/OTT.S117830

Abstract

Purpose:

Compare the lymphatic flow in the arm after breast cancer surgery and axillary lymph node dissection (ALND) versus sentinel lymph node biopsy (SLNB) using lymphos-cintigraphy (LS).

Patients and methods:

A cross-sectional study with 39 women >18 years who underwent surgical treatment for unilateral breast cancer and manipulation of the axillary lymph node chain through either ALND or SLNB, with subsequent comparison of the lymphatic flow of the arm by LS. The variables analyzed were the area reached by the lymphatic flow in the upper limb and the sites and number of lymph nodes identified in the ALND or SLNB groups visualized in the three phases of LS acquisition (immediate dynamic and static images, delayed scan images). For all analyses, the level of significance was set at 5%.

Results:

There was a significant difference between the ALND and SLNB groups, with predominant visualization of lymphatic flow and/or lymph nodes in the arm and axilla (P=0.01) and extra-axillary lymph nodes (P<0.01) in the ALND group. There was no significant difference in the total number of lymph nodes identified between the two groups. However, there was a significant difference in the distribution of lymph nodes in these groups. The cubital lymph node was more often visualized in the immediate dynamic images in the ALND group (P=0.004), while the axillary lymph nodes were more often identified in the delayed scan images of the SLNB group (P<0.01). The deltopectoral lymph node was only identified in the ALND group, but with no significant difference.

Conclusion:

The lymphatic flow from the axilla was redirected to alternative extra-axillary routes in the ALND group.

Keywords:

breast neoplasms; lymphadenectomy; lymphatic diseases; radionuclide imaging.

Conflict of interest statement

w3.org/1999/xlink” xmlns:mml=”http://www.w3.org/1998/Math/MathML” xmlns:p1=”http://pubmed.gov/pub-one”>Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1

Lymphoscintigraphy including the area from…

Figure 1

Lymphoscintigraphy including the area from the hand to the abdominal region. Notes: Sequential…

Figure 1

Lymphoscintigraphy including the area from the hand to the abdominal region. Notes: Sequential ordinal classification of the site reached by lymphatic flow from the injection site (minimum classification) to the spleen (maximum classification). Source: Reprinted with permission from Sarri AJ, Moriguchi SM, Dias R, et al. Physiotherapeutic stimulation: Early prevention of lymphedema following axillary lymph node dissection for breast cancer treatment. Exp Ther Med. 2010;1(1): 147–152.

Figure 2

Difference in lymphatic progression between…

Figure 2

Difference in lymphatic progression between the ( A ) ALND and ( B…

Figure 2

Difference in lymphatic progression between the (A) ALND and (B) SLNB groups. WBS of the ALND and SLNB groups. Notes: (A) Arrow points to the persistent visualization of lymphatic ducts in the upper limb with no evidence of lymph nodes (lymphatic stasis). (B) Arrow points to the usual visualization of axillary lymph nodes. Abbreviations: ALND, axillary lymph node dissection; SLNB, sentinel lymph node biopsy; WBS, whole-body scan.

Figure 3

WBS of the ALND group. …

Figure 3

WBS of the ALND group. Notes: Extra-axillary lymph nodes in addition to axillary…

Figure 3

WBS of the ALND group. Notes: Extra-axillary lymph nodes in addition to axillary lymph nodes. (A) Internal mammary lymph nodes on the left (short arrow). (B) Infraclavicular lymph node on the right (thick arrow), internal mammary chain lymph nodes on the left (long arrow), internal mammary chain lymph nodes on the right (short arrow). Abbreviations: ALND, axillary lymph node dissection; WBS, whole-body scan.

Figure 4

Lymphoscintigraphy. Different distributions of lymph…

Figure 4

Lymphoscintigraphy. Different distributions of lymph nodes in the ALND and SLNB groups. Notes:…

Figure 4

Lymphoscintigraphy. Different distributions of lymph nodes in the ALND and SLNB groups. Notes: (A) ALND group – Cubital lymph nodes (short arrow) slightly visible in the axillary region (long arrow). Deltopectoral lymph nodes between the two arrows. (B) SLNB group – Lymph nodes identified in the cubital region (short arrow) and well visualized in the axillary region (long arrow). Abbreviations: ALND, axillary lymph node dissection; SLNB, sentinel lymph node biopsy; WBS, whole-body scan.

See this image and copyright information in PMC

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Lymphedema | Cancer.Net

Approved by the Cancer.Net Editorial Board, 08/2019

Lymphedema is the abnormal buildup of fluid in soft tissue due to a blockage in the lymphatic system. The lymphatic system helps fight infection and other diseases by carrying lymph throughout the body. Lymph is a colorless fluid containing white blood cells. Lymph may also be called lymphatic fluid.

Lymph travels through the body using a network of thin tubes called vessels. Small glands called lymph nodes filter bacteria and other harmful substances out of this fluid. But when the lymph nodes are removed or damaged, lymphatic fluid collects in the surrounding tissues and makes them swell.

Lymphedema may develop immediately after surgery or radiation therapy. Or, it may occur months or even years after cancer treatment has ended. Most often, lymphedema affects the arms and legs. But it can also happen in the neck, face, mouth, abdomen, groin, or other parts of the body.

Lymphedema can occur in people with many types of cancers, including:

Symptoms of lymphedema

People with lymphedema in their arm or leg may have the following symptoms:

• Swelling that begins in the arm or leg

• A heavy feeling in the arm or leg

• Weakness or less flexibility

• Rings, watches, or clothes that become too tight

• Discomfort or pain

• Tight, shiny, warm, or red skin

• Hardened skin, or skin that does not indent when pressed

• Thicker skin

• Skin that may look like an orange peel (swollen with small indentations)

• Small blisters that leak clear fluid

Symptoms of head and neck lymphedema include:

• Swelling of the eyes, face, lips, neck, or area below the chin

• Discomfort or tightness in any of the affected areas

• Difficulty moving the neck, jaw, or shoulders

• Thickening and scarring of the skin on the neck and face, called fibrosis

• Decreased vision because of swollen eyelids

• Difficulty swallowing, speaking, or breathing

• Drooling or loss of food from the mouth while eating

• Nasal congestion or long-lasting middle ear pain, if swelling is severe

Symptoms of lymphedema may begin slowly and are not always easy to detect. Sometimes the only symptoms may be heaviness or aching in an arm or leg. Other times, lymphedema may begin more suddenly.

If you develop any symptoms of lymphedema, talk with your doctor as soon as possible. You will need to learn how to manage the symptoms so they do not get worse. Because swelling is sometimes a sign of cancer, it is also important to see your doctor to be sure that the cancer has not come back.

Causes of lymphedema

Lymphedema can be a long-term side effect of some cancer treatments. The most common causes of lymphedema in cancer survivors include:

• Surgery in which lymph nodes were removed. For example, surgery for breast cancer often involves removing 1 or more lymph nodes under the arm to check for cancer. This can cause lymphedema in the arm.

• Radiation therapy or other causes of inflammation or scarring in the lymph nodes and lymph vessels

• Blockage of the lymph nodes and/or lymph vessels by the cancer

The risk of lymphedema increases with the number of lymph nodes and lymph vessels removed or damaged during cancer treatment or biopsies. Sometimes lymphedema is not related to cancer or its treatment. For instance, a bacterial or fungal infection or another disease involving the lymphatic system may cause this problem.

Diagnosing lymphedema

A doctor is often able to find lymphedema by looking at the affected area. But sometimes he or she will recommend additional tests to confirm a diagnosis, plan treatment, or rule out other causes of the symptoms. These tests may include:

• Measuring the affected part of the body with a tape measure to monitor swelling

• Placing the affected arm or leg into a water tank to calculate the volume of fluid that has built up

• Creating a picture of the lymphatic system using an imaging method called lymphoscintigraphy. This is a reliable test, but it is not commonly used.

• Watching the flow of fluid through the lymph system using an ultrasound. This imaging test uses sound waves to create a picture of the inside of the body. An ultrasound can also be used to rule out blood clots as a cause of the swelling.

• Having a computed tomography (CT or CAT) scan or magnetic resonance imaging (MRI). These tests show the pattern of lymph drainage and whether a tumor or other mass is blocking the flow of the lymphatic system. Doctors do not usually use CT and MRI scans to diagnose lymphedema unless they are concerned about a possible cancer recurrence.

• Using other tools to diagnose lymphedema. These include perometry, which uses infrared light beams, or a bioimpedance spectroscopy, which measures electrical currents flowing through body tissues.

It is also important to make sure another illness is not causing the swelling. Your doctor may perform other tests to rule out heart disease, blood clots, infection, liver or kidney failure, or an allergic reaction.

Stages of lymphedema

Doctors describe lymphedema according to its stage, from mild to severe:

Stage 0. Swelling usually cannot be seen yet even though the lymphatic system has already been damages. Some people may feel heaviness or aching in the affected body part. This stage may last months or even years before swelling occurs.

Stage I. Swelling is visible but can be reduced by keeping the affected limb raised and using compression (see “Managing and treating lymphedema” below). The skin may indent when it is pressed, and there are no visible signs of skin thickening and scarring. 

Stage II. The skin may or may not indent when it is pressed, but there is moderate to severe skin thickening. Compression and keeping the affected limb raised may help a little but will not reduce swelling.

Stage III. The skin has become very thick and hardened. The affected body part has swollen in size and volume, and the skin has changed texture. Stage III lymphedema is permanent.

Managing and treating lymphedema

Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any lymphedema symptoms you have. Make sure to bring up any new symptoms or a change in your symptoms.

Lymphedema treatments:

• Reduce swelling

• Prevent it from getting worse

• Prevent infection

• Improve how the affected body part looks

• Improve the person’s ability to function

Although treatment can help control lymphedema, it currently does not have a cure. Your doctor may recommend a certified lymphedema therapist (CLT). The CLT can develop a treatment plan for you, which may include:

• Manual lymphatic drainage (MLD). MLD involves gentle skin massage. It helps blocked lymphatic fluid drain properly into the bloodstream and may reduce swelling. For best results, you should begin MLD treatments as close to the start of lymphedema symptoms as possible. A member of your health care team can refer you to a CLT trained in this technique.
• Exercise. Exercising usually improves the flow of  lymph fluid through the lymphatic system and strengthens muscles. A CLT can show you specific exercises that will improve your range of motion. Ask your doctor or therapist when you can start exercising and which exercises are right for you.
• Compression. Non-elastic bandages and compression garments, such as elastic sleeves, place gentle pressure on the affected area. This helps prevent fluid from refilling and swelling after decongestive therapy (see below). There are several options, depending on the location of the lymphedema. All compression devices apply the most pressure farthest from the center of the body and less pressure closer to the center of the body. Compression garments must fit properly and should be replaced every 3 to 6 months.
• Complete decongestive therapy (CDT). This is also known as complex decongestive therapy. It combines skin care, manual lymphatic drainage, exercise, and compression. A doctor who specializes in lymphedema or a CLT should do this therapy. The therapist will also tell you how to do the necessary techniques by yourself at home and how often to do them. Ask your doctor for a referral.
• Skin care. Lymphedema can increase the risk of infection. So it is important to keep the affected area clean, moisturized, and healthy. Apply moisturizer each day to prevent chapped skin. Avoid cuts, burns, needle sticks, or other injury to the affected area. If you shave, use an electric razor to reduce the chance of cutting the skin. When you are outside, wear a broad-spectrum sunscreen that protects against both UVA and UVB radiation and has a sun protection factor (SPF) of at least 30. If you do cut or burn yourself, wash the injured area with soap and water and use an antibiotic cream as directed by your health care team.
• Elevation. Keeping your affected limb raised helps to reduce swelling and encourage fluid drainage through the lymphatic system. But it is often difficult to keep a limb raised for a long time.
• Low-level laser treatments (LLLT). A small number of clinical trials have found that LLLT could provide some relief from lymphedema after removal of the breast, particularly in the arms.
• Medications. Your doctor may prescribe antibiotics to treat infections or drugs to relieve pain when necessary.
• Physical therapy. If you have trouble swallowing or other issues from lymphedema of the head and neck, you may need physical therapy.

Reducing your risk of lymphedema

Talk with your doctor if you have concerns about developing lymphedema. Also, try the following tips:

Related Resources

Leg Swelling After Cancer Treatment: What Can You Do?

Fear of Treatment-Related Side Effects

Side Effects of Surgery

More Information

Lymphatic Education & Research Network

Lymphology Association of North America (LANA): Find a LANA Certified Therapist

National Lymphedema Network

Download Lymphedema (PDF), a 1-page (front and back) printable overview of lymphedema, including its causes, diagnosis, and options for treatment and management; words to know; and questions to ask the health care team. Order printed copies from the ASCO Store. 

Inflammation of the lymph nodes under the arm: causes, treatment, photo

Inflammation of the lymph nodes under the arm is most often the result of an infectious disease, fungus or cancer cells.

The inflammatory process in the lymph nodes of the armpits is especially dangerous for women – this may be the first sign of breast cancer.

In some, inflammation is triggered by frequent shaving, the use of deodorants (it can clog pores with bacteria).

Please note that if inflammation occurs, it means that the number of viruses and bacteria has increased. As a result, the lymph nodes under the armpits begin to increase in size, which leads to painful sensations.

Causes of inflammation

Lymph nodes, which are located in the inner part of the shoulder crease, consist of connective tissue. It prevents the entry of viruses into the lymph. If the number of bacteria and harmful microorganisms has increased, then the lymph node becomes inflamed. It is important not to despair and remember that most often this symptom is just a consequence of a cold.

However, only a specialist can determine the exact cause of this condition, so you cannot ignore the enlargement of the lymph nodes and self-medicate. Causes of this condition include:

1. Previous infection or cold of the throat, nose or ear.
2. Inflammation of the hair follicles, which are located precisely in the armpit.
3. Intoxication of the body due to complications after influenza.
4. Inflammation of the mammary glands.
5. Profuse sweating, provoking the multiplication of bacteria and viruses.
6. Allergic reactions of various kinds. As a rule, these are reactions to deodorant, which prevents sweating.
7. Oncological disease of the lymph nodes – lymphoma. During breast cancer or any other chest organs, the inflammatory process of the lymph nodes is not often painful. Basically, inflammation is detected only by their significant increase.

The main causative agents of the inflammatory process in the lymph nodes are staphylococci, streptococci, Escherichia coli, etc. Infection with bacteria occurs in 3 ways: through the blood, lymph, and also by contact of bacteria with damaged skin.

Symptoms

You can determine the development of the disease by the following signs (see photo):

• first of all, reddening of the skin area covering the lymph node is observed;
• palpation of the affected area is accompanied by a feeling of discomfort;
• with severe inflammation, pain occurs;
• increase in body temperature;
• severe weakness when working with hands;
• nausea;
• Gradually, when feeling the lymph nodes, their pulsation is observed.

The most obvious signs of inflammation of the lymph nodes under the arm at the purulent stage. At first, the temperature rises slightly. Then, as the lymph nodes increase, there is an increase in temperature, the onset of chills and fever. The danger in this case is that purulent foci may appear in other organs.

Treatment of inflammation of the lymph nodes under the armpit

Any treatment for this disease is to block the inflammatory process, which caused an increase in the lymph nodes under the armpits, as soon as possible. As soon as the infection goes away, the lymph nodes return to their normal state.

Therefore, the main direction of treatment for inflammation of the lymph nodes should always be to eliminate its cause as soon as possible.

1. In the early stages of inflammation, try to load the affected lymph nodes as little as possible.
2. Strengthen the effect of the treatment of physiotherapy with ultrasound, electrophoresis, the use of compresses and ointments that help eliminate inflammatory processes.
3. Rapid absorption is facilitated by spraying with chloroethyl, which is combined with vaseline, troxevasin and heparin emulsion compresses.

Treatment with antibiotics and other serious medications should be done under the supervision of a doctor, based on an examination and an updated diagnosis.

There are times when the underarm lymph nodes become overwhelmed with abnormal cancer cells and the body can’t handle them safely. In this case, a cancerous disease of the lymph node may develop, it requires a long and complex treatment in a medical institution.

Folk remedies

Wat some folk recipes that you can use at home.

1. Echinacea is a good antiseptic. You can effectively remove inflammatory changes in the armpits by taking ½ teaspoon in ¼ cup of water.
2. Vitamin C is found in large quantities in the composition of citrus products, as well as in cabbage. This chemical compound is necessary to increase the rate of biochemical reactions of the body, as they are a cofactor in many diseases.

Treatment in each individual case is individual and depends on the cause of the disease. In this case, antibiotics, immunostimulants, vitamins can be used.

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What an inflamed lymph node looks like under the arm

Lymph nodes are the defense system of the human body. Their diffuse location throughout the body contributes to high-quality filtration of the entire lymphoid fluid. The axillary lymph nodes are the natural filter of the upper half of the body. If they increase, then it is possible to suspect the localization of inflammation in this particular part of the body. Therefore, it is very important to know what an inflamed lymph node looks like under the arm, a photo of which can be easily found on the Internet.

Content:

• The main groups of axillary lymph nodes
• Methods for the study of axillary lymph nodes
• How to understand that the axillary lymph nodes are enlarged and what they are normal
• Diseases that occur with an increase in nodes under the arm
• Which doctor diagnoses an increase in axillary lymph nodes

A group of axillary lymph nodes collect tissue fluid (lymph) from the upper half of the body. The lymph nodes filter and disinfect it, after which the lymph enters the large lymphoid ducts. Each person has a different number of axillary nodes. Normally, they can be from 13 to 50. Axillary nodes are divided into:

• Central – located in the center of the armpit.
• Medial – lie next to the thoracic artery.
• Subscapular – located in the armpit, in its back.
• Thoracic – also lie in the deep layers of the axillary cavity.
• Lateral (brachial) – accompany the axillary vein.

This group also includes intramammary lymph nodes, which are located in the thickness of the glandular tissue of the mammary gland. They collect lymph from the lobules of the mammary gland, as well as from the small and large pectoral muscles. The norm of lymph nodes of this subgroup is 3-5 pieces.

Non-inflamed, normal lymph nodes in adults, hardly palpable. On palpation, they should be small, painless.

Methods for examining axillary lymph nodes

If there is a suspicion that axillary lymph nodes are enlarged, then you should contact your family doctor or general practitioner. To determine the size of the inflamed node, the doctor conducts the following studies:

• Examination of the whole body and the affected area. The doctor will pay special attention to the size of the lymph nodes under the armpits, the color of the skin above it. If the intramammary node is enlarged, then the nipples and areolas, the skin of the mammary glands will be carefully examined.
• Palpation of the lymph nodes in the armpit. Attention is paid to the mobility of the nodes, their consistency, the temperature of the skin above them.

In addition to examining and probing the nodes, the doctor may prescribe laboratory techniques and instrumental studies. They will help to make sure that a pathological process develops in the body, as well as to find out its cause. The most common methods include:

• CBC and urinalysis.
• Biochemical and immunological examination of blood.
• Ultrasound examination of the lymph nodes.
• Mammography and needle biopsy.

If the process has a long course and its diagnosis is difficult to access, computed tomography and magnetic resonance imaging may be prescribed. In some cases, you may need to consult doctors of other specialties.

Important! Only after a full, comprehensive examination of the patient, the correct and effective treatment can be prescribed

How to understand that the axillary lymph nodes are enlarged and what they are like in the norm

This is how inflamed lymph nodes under the armpits look like (photo)

In order to suspect inflammation or hyperplasia of the axillary lymph nodes in time, you need to know the symptoms that accompany this pathology. Enlarged axillary lymph nodes are accompanied by the following clinic:

• The affected node is enlarged (the normal size of the nodes is not more than 10 mm). Perhaps a feeling of discomfort in the affected area, it seems that something “interferes”. Depending on how enlarged the lymph nodes under the armpits are, they can be felt or even noticed with the naked eye. With an increase in the intramammary lymph node, a seal in the mammary gland can be palpated.
• Soreness in the area of ​​the affected node. Pain can be of a different nature (aching, shooting, squeezing) and duration (constant and periodic).
• Deterioration of general condition. Since the enlargement of the axillary nodes is a symptom of various inflammatory diseases, the general condition also suffers greatly. Most often, body temperature rises, general weakness occurs, irritability appears, mood is disturbed.

If at least one of the listed symptoms is detected, you should immediately consult a specialist. The doctor will prescribe a full examination and effective treatment.

Diseases that occur with enlarged nodes under the arm

Enlarged axillary lymph nodes can be observed in a variety of pathologies. Most often these are:

• Infectious diseases. An increase in nodes is usually observed with purulent processes. For example, with boils or carbuncles located under the arm. In addition, with mastitis and mastopathy in women, the lymph nodes of this group also become inflamed.
• Violation of personal hygiene rules. With frequent and improper use of deodorants that clog the sweat ducts, there is a risk of developing infectious processes. After that, an inflammatory process may occur in the tissue of the lymph node.
• Immunodeficiencies. With such pathologies, all groups of lymph nodes usually increase. The axillary group reacts to the pathological process one of the first.
• Oncological processes. An increase in axillary lymph nodes is characteristic of both benign and malignant breast pathologies. Usually, enlarged lymph nodes do not cause any discomfort to a woman, and they are discovered by chance, for example, during a routine examination.

Because it is rather difficult to determine the cause of enlarged lymph nodes, consultations of related specialists may be required. With their help, it is possible to diagnose the disease in a timely manner and predict its course.

Which doctor diagnoses enlarged axillary lymph nodes

In order to make an accurate diagnosis and prescribe the correct treatment for enlarged lymph nodes in the axillary region, you will need to consult different doctors. Which doctor can consult:

• Gynecologist-oncologist. If you are concerned about an inflamed and enlarged intramammary lymph node. It can be felt both in the form of a soft elastic formation, and take on a dense, bumpy structure.