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Lymph node procedures

Axillary and Groin — Node Biopsy

A biopsy of a swollen node under the arm or in the groin is a short day procedure under local anaesthetic. The cause is usually infection or TB, not cancer — but a tissue sample is the only way to be certain.

Medically reviewed by Dr. Muralidhar Muddusetty, Surgical Oncologist, MBBS (AIIMS) · MS Surgery (AIIMS) · DNB Surg Onc · MRCS (Edinburgh) · Last reviewed September 2026

  • Usually infection or TB — In India, TB is one of the most common causes of a node that stays enlarged for weeks. Infection is even more common.
  • Core or excision preferred — When lymphoma cannot be ruled out, a core or excision biopsy gives the laboratory the tissue structure it needs for an accurate diagnosis.
  • Day procedure — Done under local anaesthetic. Most people go home the same day.
  • Ask about lymphoedema risk — A single diagnostic biopsy carries a low risk. The risk rises if many nodes are removed — ask your surgeon what is planned.
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A biopsy of nodes under the arm or in the groin takes a small tissue sample under local anaesthetic, usually as a day procedure. Infection and TB are more common causes of a swollen node than cancer. A single diagnostic biopsy rarely causes lasting limb swelling.

How is the biopsy done?

  1. Explanation and consent

    Your surgeon or radiologist explains the procedure. Tell your team about any blood-thinning medicines you take before signing the consent form.

  2. Local anaesthetic

    An injection numbs the skin and tissue around the node. You will feel pressure but not sharp pain during the procedure.

  3. The biopsy

    A core biopsy uses a hollow needle to remove a small cylinder of tissue. An excision biopsy removes the node whole through a small cut. Excision is preferred when lymphoma is being considered, because the laboratory needs to see the full structure of the node.

  4. Sample sent to pathology

    The tissue goes to a pathology laboratory. The pathologist examines the cells and reports findings to your doctor.

  5. Results

    Standard pathology results take one to two weeks. Tests for TB or other organisms needing culture can take several weeks longer.

Is there a risk of arm or leg swelling after this biopsy?

A single diagnostic biopsy of one or two nodes carries a low risk of lymphoedema — the persistent swelling that occurs when lymph drainage is disrupted.

The risk rises significantly when many nodes are removed in a clearance procedure, and rises further when radiation follows. If your plan involves more extensive node surgery, ask your surgeon specifically about lymphoedema risk before you proceed.

After the biopsy, tell your team promptly if you notice heaviness, puffiness or tightness in the arm or leg on that side. Early reporting gives the most options for management.

Terms your team may use

Axillary nodes
Lymph nodes under the armpit. They drain fluid from the arm, breast and chest wall.
Inguinal nodes
Lymph nodes in the groin crease. They drain the leg and lower abdomen.
Core biopsy
A needle removes a small cylinder of tissue with its structure intact — enough for the laboratory to identify the cell type.
Excision biopsy
The node is removed whole through a small incision. Preferred when lymphoma is suspected, because the full node architecture matters for diagnosis.
Lymphoedema
Swelling of the arm or leg from disrupted lymph drainage. More common after extensive node removal than after a single diagnostic biopsy.

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What does recovery look like?

Most people go home the same day. The site will be sore for a few days.

A core biopsy heals within about a week with no visible scar. An excision biopsy takes a little longer and leaves a small scar at the incision site.

Avoid lifting heavy loads with the affected arm or strenuous leg activity until the wound is healed. If the site looks red or swollen, or you develop a fever in the first week, contact your team.

What actually causes a swollen node under the arm or in the groin?

Most enlarged nodes in these areas are caused by local infection — a skin infection, small wound or ingrown hair in the area the node drains.

In India, tuberculosis is one of the most common causes of a node that remains enlarged for several weeks. The biopsy will specifically test for TB, because TB affecting lymph nodes is treated with medicines, not surgery.

Lymphoma and other cancers can cause swollen nodes, but infection and TB are more common. A biopsy result is not always a complete answer at the first attempt — some results need follow-up testing before a diagnosis is confirmed.

Questions families often ask

Why not just use a fine needle — isn't that simpler?

A fine needle aspiration (FNAC) takes individual cells but not a structured piece of tissue. When lymphoma cannot be ruled out, the laboratory needs to see how the cells are arranged within the node — which a fine needle cannot provide. If FNAC is done first and the result is inconclusive, a core or excision biopsy typically follows. Your surgeon will advise which approach is right for your situation from the start.

Will the biopsy give a definitive answer?

A biopsy is the most reliable method for examining the node directly, but it does not guarantee a complete answer in one step. The sample may not capture the abnormal area, or the pattern may be ambiguous. TB culture results take several weeks. Your oncologist will explain what the result showed and whether further testing is needed before a diagnosis is confirmed.

Can we wait and see if the node goes down on its own?

If infection is the most likely cause, your doctor may suggest a short course of antibiotics first and then reassess. A node that is shrinking is reassuring. One that stays the same size for several weeks, continues to grow, or appears alongside weight loss, night sweats or persistent fever is one that needs a biopsy rather than more watching. Your doctor will advise whether waiting or proceeding is right for your situation.

What happens if the result shows TB?

You will be referred to a physician who manages tuberculosis. Treatment involves a course of antibiotics taken over several months — the duration depends on the extent of the disease. TB of the lymph nodes does not require further surgery to remove additional nodes. Your care team will explain who manages the next step and what to expect during treatment.

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Common questions

Frequently asked questions

Do I need a general anaesthetic for this biopsy?

Most axillary and groin node biopsies are done under local anaesthetic as a day procedure. General anaesthetic is occasionally used if the node is deep, if the procedure is combined with another operation, or if local anaesthetic is not suitable for you. Your surgeon will explain which applies when you discuss the consent form.

How long do biopsy results take?

Standard pathology results are usually ready in one to two weeks. Tests for TB or organisms that need to be grown in culture take several weeks longer. Ask your team which specific tests have been ordered so you have a realistic timeline rather than assuming all results come back at once.

What if the biopsy result comes back inconclusive?

An inconclusive result means the sample did not provide enough information for a diagnosis — not that the node is normal. Your surgeon or oncologist will advise whether to repeat the biopsy, take a larger sample through excision, or do additional imaging first. An inconclusive result is a step in the investigation, not the end of it.

What is my actual lymphoedema risk from a diagnostic biopsy?

A single diagnostic biopsy of one or two nodes carries a low lymphoedema risk. The risk rises substantially when many nodes are removed — particularly in a full clearance combined with radiation. If your plan includes a clearance procedure, ask your surgeon to explain the specific risk and what steps can reduce it.

Can I have this biopsy if I am taking blood thinners or aspirin?

Tell your surgical team about every medicine you take — including aspirin, clopidogrel, warfarin, and newer anticoagulants — before the procedure. They will advise whether to pause any medicine and for how long. Do not stop any medicine without being told to, as some should not be stopped suddenly.

Is this procedure available at CION?

Yes. Axillary and groin node biopsies are available at CION centres, usually as day care. If the result indicates that further imaging such as a PET-CT is needed, that is coordinated through partner imaging centres. Your care team will explain the next steps once results are available.

Full index

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