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Sentinal Node Biopsy

Sentinel node biopsy is a relatively new way of pinpointing the first few lymph nodes into which a tumor drains (called the "sentinel" nodes). This helps doctors remove only those nodes of the lymphatic system most likely to contain cancer cells. The sentinel nodes are the first place that cancer is likely to spread. Usually one to four lymph nodes are removed.

In breast cancer, the sentinel node is usually located in the axillary nodes, under the arm. In a small percentage of cases, the sentinel node is found somewhere else in the lymphatic system of the breast. If the sentinel node is positive, there may be other positive lymph nodes upstream. If it is negative, it is highly likely that all of the upstream nodes are negative.

How is the procedure performed?

To locate the sentinel nodes, a labeling substance, radioactive tracer, or blue dye, or both, is injected into the area around the tumor before a mastectomy or lumpectomy is performed. The tracer travels the same path to the lymph nodes that the cancer cells would take, making it possible for the surgeon to determine the one or two nodes most likely to test positive for cancer by either visualizing the color or using a handheld Geiger counter.

What are the advantages of this method?

Research suggests that the sentinel node biopsy procedure can be useful in determining which lymph nodes to remove, without the risk of complications associated with surgically removing all potentially cancerous nodes. Many women experience arm swelling, discomfort and limited range of motion after having many of their axillary nodes removed.

When a lumpectomy or mastectomy is performed, only a few lymph nodes are removed for laboratory analysis using the sentinel node biopsy technique. In traditional lumpectomy or mastectomy procedures, a greater number of the axillary nodes are removed, which can lead to complications after surgery such as lymphedema which is an incurable chronic condition that results in arm swelling.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/10/2012..#9192