How is it determined if breast cancer hasn't spread to other lymph nodes outside of the arm? Is there additional testing that is needed?

I have a lymph node dissection scheduled in my left arm on July 16th. How do we know the cancer has not spread to other lymph nodes outside of the arm? Is there testing I need to recommend?

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DrAttai (Physician - Surgery - Breast (Verified) ) - 06 / 13 / 2012

In general, if there has been no spread to the underarm lymph nodes, it is not likely that there has been spread to other lymph nodes. However there are a few situations where the cancer might spread to other lymph nodes and not the underarm nodes - primarily lymph nodes within the chest, called the internal mammary nodes - this is usually seen on an MRI or other scan.

If underarm lymph node spread has not occurred and if the tumor is less than 2cm in size (considered a Stage I breast cancer), full body scans such as a CT scan or PET scan are not recommended by the NCCN guidelines ( National Comprehensive Cancer Network - www.nccn.com ,http://www.nccn.com/files/cancer-guidelines/breast/index.html ).
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