What to expect with ALND

Jacklin

Due to my diagnosis based on clinical examination and core biopsy, I will be having an ALND with my BMX at the end of April. My BS has indicated that I will have 1 incision on each side and she can perform the ALND from that incision site rather than making a new one under my arm. If you've had an ALND, could you share you post-operative experiences with me? What does the site look like? How was your recovery? Is there anything in particular you would suggest/not suggest in terms of healing? I appreciate all your suggestions/advice, thank you for helping me prepare myself.

ElaineTherese

I had an ALND with my lumpectomy. The surgeon ended up taking out 20 lymph nodes (Levels 1 and 2) from my right armpit. The site looks OK; the incision was across my pit and doesn't show unless I raise my arm. Recovery was fine, though the site was numb (surgeon had to cut across some nerves). The surgeon gave me a brochure with illustrated exercises to perform so that I could regain my range of motion. I also found swimming to be useful in regaining my strength. It is important to keep an eye out for lymphedema with ALND. You might want to get a certified lymphedema physical therapist to measure you before surgery and then after. Luckily, I don't have lymphedema (yet!), but it's a relatively common complication from ALND. To familiarize yourself with lymphedema, you might want to visit the lymphedema threads on this board. Good luck!

SpecialK

I did not have ALND with my BMX as my SNB did not show any issues until it was more thoroughly dissected in the lab - I had 20 isolated tumor cells (IST), and being Her2+ meant ALND surgery five weeks later. Both BS and MO were immovable on this. My incision is across the lower underarm, it was under stitched and glued and is now so faint it isn't seen. I do have a bit of a hollow in the underarm, but nothing particularly noticeable. Levels 1&2 yielded only another 11 nodes, one of which was large and positive. I did have numbness in the axilla and down to the elbow, which gradually resolved, but very slowly - it took the better part of a year for the arm to regain feeling. I had skin hypersensivity on the arm so skin to skin contact bothered me more than wearing something with sleeves, and initially I rested with a pillow under my arm. Most with ALND are advised to wait a couple of weeks before lifting the arm higher than elbow level to allow for healing. I echo the advice re arm measuring.

Jacklin

Thank you ElaineTherese and SpecialK for the suggestions, I will be sure to get a referral to a lymphedema specialist. I so appreciate your responses and have a bit more understanding of what to expect after my surgery.

Have a good evening,

Jacklin