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:
If the lymph nodes are removed, there is an increased risk of the following:
Some factors that may increase the risk of complications include:
Your doctor will do a physical exam. The cancerous tissue will be biopsied. Tests may include the following:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Depending on the location of the lymph node, you may be given one of the following:
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.
The biopsy takes about 30-60 minutes. Surgery to remove the entire cancer takes longer.
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 instructions. Keep the surgical area clean and dry.
If you develop complications from lymph node surgery, you will need to take some special precautions:
After arriving home, contact your doctor if any of the following occurs:
If you think you have an emergency, CALL 911.
RESOURCES:
American Cancer Society
http://www.cancer.org/
National Cancer Institute
http://www.cancer.gov/
CANADIAN RESOURCES:
Canadian Cancer Society
http://www.cancer.ca/
Health Canada
http://www.hc-sc.gc.ca/index-eng.php
References:
Abeloff M. Clinical Oncology. 2nd ed. New York, NY: Churchill Livingstone, Inc.; 2000.
Alazraki NP, Styblo T, Grant SF, et al. Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma detecting probe. Radiol Clin North Am. 2001;39:947-956.
American Cancer Society website. Available at: http://www.cancer.org.
Conn HF, Rakel R. Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002.
Dauway EL, Giuliano R, Haddad F, et al. Lymphatic mapping in breast cancer. Hematol Oncol Clin North Am. 1999;13:349-371.
Leong SP. The role of sentinel lymph nodes in malignant melanoma. Surg Clin North Am. 2000;80:1741-1757.
Sentinel lymph node biopsy: questions and answers. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/sentinel-node-biopsy. Accessed July 21, 2009.
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. BMJ. 2010;340:b5396.
Last reviewed November 2009 by B. Gabriel Smolarz, MD
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 medical condition.
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