Sentinel Node Biopsy

A Sentinel Node Biopsy is a surgical procedure used to determine if cancer has spread to the lymph nodes by removing the first lymph node(s) where cancer cells are most likely to spread. These nodes are called sentinel nodes and are crucial for assessing cancer spread.

A Sentinel Node Biopsy is done under general anesthesia, so you’ll be asleep and pain-free during the procedure. 

First, a small amount of a radioactive tracer is injected into the breast near the tumor. The tracer travels through the lymphatic system and collects in the first lymph node(s) where cancer is most likely to spread – the sentinel node(s).

To make the nodes easier to see, a blue dye may also be injected. The surgeon then uses a special device called a gamma probe to detect the radioactive tracer and locate the sentinel node(s). 

Once located, the surgeon makes a small incision in the armpit area (or sometimes other areas) to remove the sentinel node(s).

This procedure is often done along with other surgeries, like a lumpectomy or mastectomy, to get a complete picture of the cancer’s spread. The procedure takes about 1-2 hours, and most patients can go home the same day.

The biopsy provides critical information about whether cancer has spread to the lymphatic system, which helps guide further treatment decisions. If the sentinel nodes are clear, it indicates that the cancer is less likely to have spread to other lymph nodes, potentially avoiding more invasive procedures.

The sentinel node is the first lymph node that cancer cells are likely to spread to from the tumor. It is typically located in the armpit but can also be found in areas such as above or below the collarbone or between the ribs.

Sentinel nodes are located using a combination of techniques. A radioactive tracer is injected around the tumor site, which then travels to the sentinel node. On the day of surgery, a blue dye is also injected to help identify the node visually. A gamma probe is used to pinpoint and remove the sentinel node(s).

If cancer is found in the sentinel node, further surgery may be required to remove additional lymph nodes and determine how far the cancer has spread.

If the sentinel node is clear, it’s likely that the cancer has not spread to other lymph nodes, which could reduce the need for further surgery and decrease the risk of complications.

Alternatives to a sentinel node biopsy include:

• Axillary node clearance, where all lymph nodes under the arm are removed.
• Axillary node sampling, which involves removing only a sample of lymph nodes.

Axillary clearance is more invasive and comes with higher risks, while axillary sampling is less accurate.

Before the biopsy, you’ll receive a radioactive injection, usually in the morning or the day before surgery. This is followed by imaging to map the lymphatic pathways, helping your surgeon locate the sentinel node. Your surgeon will provide specific instructions regarding preparation.

Recovery time varies, with some patients going home the same day. Discomfort and swelling in the area of the incision are common. Most patients can resume normal activities within a few days, but strenuous exercise should be avoided for some time.

Dr. Nasrin Davarpanah will be with you every step of the way to support your recovery.

Like any surgery, a Sentinel Node Biopsy carries some risks. While it is generally safe, potential complications include an allergic reaction to the dye, false negative results, or discomfort around the incision site. Your surgeon will discuss these risks with you so that you can make an informed decision.

The sentinel node biopsy typically takes 1-2 hours. It is usually done in conjunction with other procedures like lumpectomy or mastectomy to fully assess the cancer.

The need for further treatment depends on the biopsy results. If cancer is found in the sentinel node, further surgery or other treatments like chemotherapy or radiation may be necessary.

Yes, you will not be radioactive after the procedure, so it is safe to be around your family.