Sentinel Lymph Node Biopsy: What Is It?

What is a Sentinel Lymph Node Biopsy?

biopsyWith so many breast cancer terms, men and women are often overwhelmed, especially when there’s a term like sentinel lymph node biopsy.

Although the term may sound quiet confusing and intimidating, this technique can help clarify the stage of your cancer.

Medical Director Dr. Jay Harness explains, “A sentinel lymph node biopsy is a selective biopsy of one up to may be four lymph nodes in the armpit area.”

This procedure can be used to see if a known cancer has spread from the original cancer site. There are couple of different ways of doing the sentinel lymph node technique.

Find out from Dr. Jay Harness what a sentinel lymph node biopsy is and the different ways of performing this technique.

Transcript

Jay K. Harness:  The term sentinel lymph node biopsy can be a little bit confusing, what is it?  It is a technique or biopsy that helps us to clarify the stage of your cancer.  Let me explain.

A sentinel lymph node biopsy is a selective biopsy of one up to may be four lymph nodes in the armpit area.  Where does the term sentinel come from?

The concept here is that if you are going to have cancer cells in your lymph nodes then it makes really good sense that the first lymph nodes that the lymphatic fluid flows through from your breast would be the logical place that these cancer cells would settle out and potentially grow.

This is a technique now, it has been around for over a decade and it has been proven to be very valid and there are couple of different ways of doing the sentinel lymph node technique.

One of the most common is the day of surgery or the evening before that is around the nipple areolar area to inject what is called radioactive isotope, bit fancied term but it is a material that will then migrate through the lymphatic channels and settle out in the initial lymph nodes draining your breast.

Now, it will sit there for many hours which is a good news and because it is radioactive, we can use a little geiger counter in the operating room to find them and so what we do at the time of a lumpectomy or a mastectomy is to biopsy these initial lymph nodes draining the breast.

If we are doing a mastectomy, we will probably have the pathologist do a frozen section because we may need to remove the rest of the lymph nodes if the sentinel lymph node is positive.

However, more recently with lumpectomy patients, if the sentinel lymph node was positive, we don’t necessarily have to remove the rest of the lymph nodes.

Now, the good news is that in the majority of cases, all the lymph nodes don’t need to be removed and if we are only sampling a few of them, then there is a less chance of swelling of the arm or any other kinds of complications.

So, the sentinel lymph node technique is indicated when we think the lymph nodes are normal and at the time of surgery to help us stage your disease and to determine additional treatment.

Dr. Jay Harness is a surgeon specializing in complete breast health, breast cancer surgery, oncoplastic reconstruction, genetic screening, risk assessment and counseling, management of breast health issues and breast cancer treatment in Orange County, California. Dr. Harness completed his general surgery residency at University of Michigan Hospitals and Health Centers.