Some circumstances make a complete node dissection necessary.
Also, some surgeons recommend only total node dissections. In these cases there is no decision for the woman to make. One problem with removing lymph nodes is that women can have arm swelling and arm pain later on. These problems can be severe, or quite bothersome, even if not severe. Node sample is based on the principle that cancer usually spreads first to the nodes near the breast and later to other lymph nodes.