A sentinel lymph node biopsy is the removal and testing of specific lymph node tissue.
A sentinel lymph node biopsy is often done during cancer-removal surgery or prior to surgery. The sentinal nodes are the lymph nodes to which cancer would spread first. Sentinel node biopsy is part of the staging process. Staging is an attempt to determine how much the cancer has spread away from the original tumor.
This biopsy is done to determine if cancer cells have spread from the tumor to nearby lymph nodes. Cancer often spreads from the tumor to the nearest lymph node or nodes. These lymph nodes are called the sentinal nodes. It is important to understand that the sentinel node will probably be the first one to get cancer if the cancer has spread. In the case of breast cancer, the sentinal nodes are often found in the armpit.
Complications are rare, but no procedure is completely free of risk. If you are planning to have this biopsy, your doctor will review a list of possible complications which may include:
Bleeding or bruising
Allergy to dye
If the lymph nodes are removed, there is an increased risk of the following:
Delayed wound healing
(a condition in which fluids collect under the skin causing swelling)
Some factors that may increase the risk of complications include:
A blue dye, and often a radioactive tracer, will be injected into the area where the tumor is. It may be done several hours before surgery. The dye and tracer will travel from the tumor area to the sentinal nodes. This will help identify which nodes are the sentinel lymph nodes. The doctor will make a small incision. The sentinel node (or nodes) will be removed. The removed node will be checked for cancer cells. If cancer is found, the doctor will remove the rest of the lymph nodes in that area.
If cancer is not seen in the sentinel node, it is unlikely that the cancer has spread to the other remaining lymph nodes. The other lymph nodes are not removed.
How Long Will It Take?
The biopsy takes about 30-60 minutes. Surgery to remove the entire cancer takes longer.
Will It Hurt?
Anesthesia prevents pain during surgery. Pain medicines are given during recovery.
The result of the sentinel lymph node biopsy determines if additional lymph nodes need to be removed. It can also help determine the severity of your cancer.
Be sure to follow your doctor's
Keep the surgical area clean and dry.
If you develop complications from lymph node surgery, you will need to take some special precautions:
Do not have blood pressure taken, blood drawn, or shots given in that arm.
Wear gloves to do dishes, household scrubbing, and yard work.
Do not wear anything tight on that arm, including elastic in sleeves.
Do not carry heavy packages, purses, suitcases, grocery bags, etc. with that arm.
Keep the skin of that arm well-moisturized with a lanolin-containing product.
Use an electric shaver if you wish to shave your armpits.
If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
If lymph nodes were removed: redness, warmth, swelling, stiffness, or hardness in the extremity
Fingers and toes should always be warm and pink. Call your doctor if they become dusky or swollen.
Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
Pain that you cannot control with the medicines you have been given
Veronesi U, Paganelli G, Viale G, et al. Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomized controlled study.
Lancet Oncol. 2006;7:983-990.
1/22/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a