I am a newly diagnosed breast cancer patient and my surgeon wants me to choose between total axillary dissection and sentinel lymph node biopsy. What is the difference between these two procedures?

Axillary lymph nodes are located under your arm. They are small and round structures that are part of the immune system designed to protect the body against disease. They are also the site of tumor metastasis. This means that when breast cancer spreads, axillary lymph nodes are the first place that the tumor cells reside. The status of tumor spread into the lymph nodes is the most well-established predictor of the outcome of breast cancer patients. It also directs the extent of therapy. Presence of tumor cells in axillary lymph nodes requires more aggressive therapy. Assessment of the presence or absence of tumor cells in axillary lymph nodes requires surgical sampling of the nodes. This can be achieved either by removal of the entire axillary lymph node, called total axillary dissection, or by removing the first few nodes, known as sentinel lymph node biopsy. Total axillary dissection is occasionally associated with the some degree of morbidity, such as lymphedema, pain or altered ...  more