Sentinel Node Biopsy
What is a Sentinel Node Biopsy?
A sentinel lymph node biopsy is a surgical procedure used in the treatment of breast and some other cancers. This procedure is based on the concept that the first lymph node (or group of nodes) that the cancer cells are likely to spread to from the primary tumor is the "sentinel" node.
What are the steps involved in performing a Sentinel Node Biopsy?
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Mapping the Sentinel Lymph Node: Prior to or during the operation, either a dye or a radioactive substance is administered near the tumour. This substance follows the route that cancer cells might take to the sentinel lymph nodes. This procedure, also known as Lymphoscintigraphy, helps the surgeon identify the lymphatic drainage pathways of the breast through provided images.
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Biopsy Procedure: During the procedure, after the sentinel lymph nodes have been accurately identified through Lymphoscintigraphy, the surgeon proceeds to make a precise, small incision in the armpit area, which is technically referred to as the axilla. This incision is strategically placed to provide optimal access to the sentinel lymph nodes while minimizing tissue damage and potential scarring.
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Pathological Examination: The identified sentinel lymph nodes are carefully excised for further pathological examination. This step is crucial as these nodes are the first ones that breast cancer cells are likely to spread to from the primary tumor. Removing and analyzing these nodes helps determine whether cancer has spread beyond the breast, thereby guiding subsequent treatment decisions and strategies.
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Determining Further Treatment: The presence or absence of cancer cells in these nodes helps determine the stage of the cancer and can influence how the rest of the treatment is planned. If the sentinel nodes are cancer-free, it's likely that cancer has not spread, and further treatment of the nodal region is not necessary.
This procedure is important because it can help avoid a full lymph node dissection, which can have more side effects, such as lymphedema (swelling due to lymph fluid build-up). It's a less invasive way to check if the breast cancer has spread to the lymph nodes, which is a key factor in determining the treatment approach.
What's New in Sentinel Node Biopsy Procedures?
Sentinel node biopsy, a key procedure for assessing the spread of breast cancer, traditionally involves an incision in the armpit to access lymph nodes. However, a newer, minimally invasive technique now allows surgeons to reach these nodes through the breast itself in suitable candidates.
Benefits of the New Approach
This method eliminates the need for an axillary incision, offering significant advantages:
- Reduced scarring: The incision is made near the tumour site within the breast, minimising visible scars.
- Less discomfort: Avoiding an armpit incision reduces recovery discomfort, particularly in the shoulder and arm.
- Quicker recovery: With fewer incisions, patients experience a smoother and faster recovery, easing their return to daily activities.
This advancement not only maintains the effectiveness of sentinel node biopsies but also enhances patient comfort and satisfaction, marking a significant step forward in the surgical management of breast cancer.
