Breast Cancer : 42 Lymph Nodes removed?
June 12th, 2009 | 
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Hi everybody,
My wife has a cancer stage 2A (tumor 2.5cm, grade 3, nipple affected) and she just went through a mastectomy (one breast removed). After some search, I realized that most of the people have an average of 15 lymph nodes removed.
Do you think the surgeon was too extreme by removing 42 Axillary Lymph Nodes or the number does not matter?
Thanks,
Andre
None of the nodes had cancer
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i dont think it matters cause they have to make sure they take off all of the lymph nodes that are affected, im so sorry to hear that though, i know exactly what you guys are going thru, i had my sister going thru all that as well, good luck!
The number of axillary lymph nodes varies from person to person. Some people have as few as 5, though 42 is the most I’ve heard of someone having.
I’m not sure where the average of 15 removed comes from. As the number people have varies so widely, it would seem difficult to find an average.
You don’t say how many were found to be cancerous. I had all mine removed - 21 - and 13 of them turned out to be cancerous.
A friend also had complete axillary clearance - 30 - and 23 were cancerous; another friend also had all her axillary lymph nodes removed - 9 - and all 9 were cancerous.
I feel sure that the surgeon removed the number s/he felt was necessary to ensure as far as possible that the cancer was removed; possibly the number affected was so great that complete clearance was the only reasonable option.
My best wishes to your wife for her recovery and for the rest of her treatment
The goal of an axillary lymph node dissection is to remove all the nodes present in the axillary area. The primary goal is to get a thorough examination of all lymph tissue to accurately assess the extent of disease. There is some thought that there is also a therapeutic benefit as well, with women who have more lymph nodes removed fairing better, although this is less clear.
There is no doubt that 42 nodes removed is a lot and you are right - the average number removed today is likely about 12-15. In previous studies where less complete nodal dissections were performed the goal was to remove more than 8-10 nodes to get accurate information.
I would say that your surgeon did a very complete dissection, although you would have to be in the operating room watching to know whether to limits used for the dissection were more or less than is typical. Given the fact that none of these were involved (otherwise would be stage IIB) bodes well for your wife prognostically (other factors would have to be known to get a better estimate of her prognosis).
Good luck, and hope this helps.
No he wasn’t too extreme. When a surgeon removes the axilla they do not know how many lymph nodes they are removing and usually do the surgery the same way each time. It is up to the pathologist to sift through the specimen to find the lymph nodes, count them and look at them under a microscope. It is a difficult process and some pathologists are better at it than others. When you see “X” number of lymph nodes were removed this is how many were examined by the pathologist, but the actual number removed is often higher. In breast cancer cases it is best for the pathologist to look at as many lymph nodes as possible to get the best reading. In your wife’s case it sounds like the pathologist did an excellent job.
I went through lymph node removal last Sept. and the surgeon used dye to see which lymph nodes needed removed. My lump was large and only had two main nodes and six small ones removed-four were stuck together…
my surgeon told me that u they dont know how many lymph nodes r there exactly its like a clump so she had many lymphnodes i had friend that had 33. but the good news for your wife is that it was not in the cancer was not in the lmymp nodes that means it should not have spread. i hope yall r both doin well. everything will be ok i had a double mastectomy a month ok and it hurts at first but shell get thru it. god bless