Sentinel node biopsy is a new surgical procedure, still being tested in clinical trials. Research conducted to date has fewer side effects than the standard surgery to remove lymph nodes (axillary node dissection or axillary clearance).
Sentinel node biopsy is being tested in clinical trials to see:
- if it can accurately find out whether cancer cells have spread to the lymph nodes
- what (if any) side effects it has.
A sentinel node biopsy means surgery to remove the sentinel lymph node or nodes. There can be more than one sentinel node. The sentinel node is the first lymph node that breast cancer cells may spread to outside the breast. In most cases, the sentinel node is in the armpit.
However, sometimes the sentinel node is in a different area of the body, such as a lymph node under the breastbone or above the collar bone.
There are different ways to find the sentinel node. In one technique, a slightly radioactive substance is injected around the breast cancer. Special scans are used before and during surgery to find out which lymph node the radioactive substance has travelled to. This is the sentinel node, and is removed during surgery.
Another technique is to inject a blue dye around the breast cancer. The injection is given in the operating theatre just before breast surgery. The surgeon can see and remove the sentinel node because it turns blue when the dye travels to it. Your urine may be blue for the next 24 hours after surgery, and the skin of your breast may be blue. The blue colour will fade over time.
After the sentinel node has been removed, a pathologist examines it for cancer cells. If cancer cells are found, further surgery to remove more lymph nodes, and/or radiotherapy to the area may be needed. If the pathology tests are done during the operation and cancer cells are found, it is sometimes possible to do the additional surgery during the same operation. However,a second operation is sometimes needed.
While sentinel node biopsy has been shown to be an accurate way of finding out whether breast cancer has spread to the lymph nodes in women with early breast cancer trials are ongoing to investigate its use in larger breast cancers and DCIS. It is important that women discuss the risks and benefits of both procedures with their surgeon before surgery.
