What is a sentinel node biopsy for breast cancer?

Sentinel nodes are a small cluster of lymph nodes to which cancer first spreads from the primary tumor. In a sentinel node biopsy, a surgeon removes only one or a few of the sentinel nodes instead of the larger number of nodes typically removed for biopsy. The surgeon identifies the sentinel nodes to remove by injecting a radioactive tracer substance or dye near the tumor. Then, using a scanner, he or she searches for the nodes containing the dye/tracer and removes them to check for cancer cells.

A study reported in a 2003 issue of the New England Journal of Medicine found that sentinel node biopsies of women with small breast cancers caused fewer side effects (such as swelling, pain and numbness) than conventional biopsy procedures and was a safe and accurate way to evaluate lymph nodes in women with small breast cancers.
Dr Camille

Whenever there is cancer in the body, its primary goal is to spread to other areas. Spreading of cancer (also known as metastasis) can occur via 3 modalities: 1. Direct extension; 2. blood vessels; or 3. the lymph nodes. The Sentinel lymph node is very important as it is the first lymph node that the cancer cells tend to encounter when trying to leave the area of origin. As a "guard" lymph node it will attempt to stop the tumor cells from spreading to other areas in the body. During breast cancer surgery, your surgeon will check to see if there are cancer cells in these "guard" lymph nodes (under the arm for breast cancer) and determine if it is necessary to do a full dissection (Axillary Lymph Node Dissection; ALND). Watch video on sentinel Lymph nodes biopsy at ... the 2nd one on the home page.

Stuart A. Linder, MD
Plastic Surgery

Sentinel nodes are often referred to as a lymph node in the axilla where the breast cancers will first spread.  Sentinel node biopsies may be performed using a blue dye injected into the breast prior to surgery in order to determine whether there is lymphatic spread of the tumor into the sentinel node.  Once the isotope has been injected, it may move from the tumor through the lymphatics and into the sentinel node, aka, the first node to turn blue.  Positive sentinel nodes are important when determining surgical management as well as radiation, chemotherapy and postoperative tamoxifen therapy.

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