Medical Oncologist
Before your operation
Axillary ultrasound and node biopsy before surgery
An axillary ultrasound scans the lymph nodes in your armpit before surgery, looking for any that appear abnormal. If one does, a needle sample is usually taken at the same appointment. The answer changes which operation you are offered. This page explains what the scan can see, and the important thing it cannot.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
The short answer
Why scan my armpit before surgery?
An axillary ultrasound is a scan of the lymph nodes in your armpit, done before surgery. It is looking for nodes that appear abnormal. If one does, a needle sample is usually taken from it there and then, and the answer changes what operation you are offered.
Why the armpit matters so much
Fluid draining from the breast passes through the nodes in the armpit. If cancer cells have left the lump and settled anywhere, this is the first place they usually reach. Knowing before surgery whether they have lets your team plan one operation rather than two.
What the scan is actually looking at
Not size alone. A normal node has a thin outer rim and a fatty centre. Cancer tends to thicken that rim or push the fatty centre aside. The radiologist is looking at that shape and structure, which is why a node that feels normal to you can still be flagged.
Nodes also swell from infection, recent vaccination and inflammation. An abnormal-looking node is not a diagnosis.On the day
What the appointment involves
The scan itself
You lie with your arm raised behind your head. Gel is put on the skin and a handheld probe is moved over the armpit. It is painless and takes only a few minutes. There is no radiation.
If everything looks normal
Nothing further is done. You go on to surgery with a plan to check the first nodes during the operation instead. A normal scan does not prove the nodes are clear, and your team will say so.
If a node looks abnormal
A sample is usually taken during the same appointment, with local anaesthetic. Either a fine needle drawing out cells, or a slightly larger needle taking a small core of tissue.
Afterwards
A plaster and some bruising. You can go home straight away and use the arm normally. The result takes a few working days and is discussed at your next appointment.
Not sure whether this applies to you?
Ask an oncologistWhat it changes
How the result shapes your operation
This scan exists to avoid putting you through two operations when one would do.
A clear scan
You are usually offered a sentinel node procedure, where only the first few nodes are removed and checked. This is the smaller operation with far less risk of lasting arm swelling.
A positive needle sample
Your team knows before theatre that nodes are involved. That may mean planning more extensive armpit surgery, or planning chemotherapy before surgery instead.
Knowing early often means fewer operations overall.An abnormal node with a clear sample
The needle may have missed, or the node may be reactive rather than involved. Most teams proceed as though the nodes are clear and check again during surgery.
It can redirect the whole plan
In some subtypes, finding involved nodes leads to chemotherapy before surgery rather than after, because the response then guides what treatment is added later.
Worth asking
- Did the scan change my operation
- Was a node sampled, and what did it show
- Does this change the order of my treatment
Talk to our team
Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Side by side
The scan and the sentinel node operation
Axillary ultrasound
Sentinel node procedure
Before surgery, in the scan room, awake
During surgery, under anaesthetic
Looks at the shape of nodes from outside
Removes the first nodes and examines them fully
Finds clearly abnormal nodes; misses small deposits
Finds small deposits too
No lasting effect on the arm
Small risk of arm swelling and numbness
Decides which operation to plan
Decides your node stage
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Being straight with you
What this scan cannot tell you
A normal axillary ultrasound does not prove your nodes are clear. It sees shape and structure from outside the body, and a node holding only a few cancer cells usually looks entirely normal on it.
Why you still need the operation to know
This is the most common misunderstanding. Women are told the armpit scan was normal, then find that nodes are removed at surgery anyway and one turns out to be involved. Nothing went wrong. The scan was never able to answer that question definitively.
And the reverse happens too
A node can look abnormal because of a recent infection, a vaccination in that arm, or long-standing inflammation. This is why an abnormal appearance is sampled rather than acted on. Mention any recent illness or injection to the radiologist.
What to take from it
Read it as a planning test, not a verdict. Ask what it changed about your operation, and ask what the plan is if the nodes removed at surgery turn out differently from what the scan suggested. Both answers should be ready before the day.
Who reads it, and who decides
The radiologist describes what the nodes look like and takes the sample. Your surgeon and oncologist then decide what to do with that information, usually at a tumour board where the scan, the biopsy and your own preferences are discussed together. If the report worries you, the person to ask is your surgeon rather than the scanning department, because they are the one weighing it against everything else.
Commonly believed
What women assume about the armpit scan
The scan was normal, so my nodes are clear.
It means no node looked abnormal from outside. Small deposits are invisible to ultrasound, which is exactly why the first nodes are still removed and examined during surgery. A normal scan is encouraging, not conclusive.
A swollen node means the cancer has spread.
Nodes swell for many reasons, including infection and recent vaccination in that arm. That is why an abnormal node is sampled with a needle rather than assumed to be cancer. Tell the radiologist about any recent illness or injection.
The needle test will spread the cancer.
This belief causes real delay and it is not what happens. The needle track is not a route the cancer travels. Refusing the sample means going into surgery without information that could have spared you a second operation.
If nodes are involved, nothing more can be done.
Involved nodes change the plan; they do not close it. Many women with node-positive breast cancer are treated with the intention of clearing it completely. What the finding does is add treatment, not remove options.
Questions we are asked
Common questions about axillary ultrasound
Does the needle sample hurt?
Local anaesthetic is used, so most women describe pressure and a brief sting. The armpit is a sensitive area and it can ache for a day or two afterwards. Simple painkillers are enough for almost everyone.
If the scan is normal, can I skip node surgery?
Generally no. Because ultrasound cannot see small deposits, the first nodes are still removed and checked during your operation. That is what gives your node stage. The scan decides which operation to plan, not whether to check at all.
Why was my node sampled when it felt normal to me?
Because the radiologist is looking at internal structure rather than size. A node with a thickened rim can be entirely impossible to feel. Being unable to feel it is not a reason to skip the sample.
How long do results take?
Usually a few working days, and they are discussed at your next appointment rather than telephoned. If your surgery date is close, tell the team, because urgent samples can be flagged and turned around faster.
Can I have the scan if I am pregnant?
Yes. Ultrasound uses sound waves, not X-rays, and is safe in pregnancy. It is often the imaging of choice for exactly that reason. Tell the team you are pregnant so the rest of your plan is arranged around it.
Does a clear needle sample mean the node is definitely clear?
Not definitely. The needle samples a small part of the node and can miss a deposit. Your team treats a clear sample as encouraging and still checks the nodes during surgery. Ask what your plan is on that basis.
Will this scan show if the cancer has spread elsewhere?
No. It looks only at the armpit. Whether disease has reached the bones, liver or lungs is a different question, answered by other scans when your stage and symptoms give a reason to look. Ask whether you need those at all.
Should I be scanned on the other side too?
Not routinely. The armpit on the side of the cancer is where drainage goes. The other side is checked only if there is a specific reason, such as a lump you have noticed there or disease in both breasts.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. Each centre also names the areas it serves, so you can place it without a map. Consultation and day-care Chemotherapy run at every one of them.
Warangal
Vizag
Talk to our team
Speak to a breast cancer specialist
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Sources
- Cancer Research UK — Tests to diagnose breast cancer
- National Cancer Institute — Sentinel lymph node biopsy
- Breast Cancer Now — Tests before breast cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.