Why pick nodes in the armpit? Sentinel lymph node in breast cancer.
Introduction
When someone is diagnosed with breast cancer, one of the most critical steps is determining if the cancer has spread beyond the breast. A sentinel lymph node biopsy (SLNB) is a commonly used procedure to check for cancer in the lymph nodes, which play an essential role in the body’s immune system. This minimally invasive procedure helps doctors decide the best course of treatment while minimizing unnecessary surgeries and complications.
What is a Sentinel Lymph Node?
Lymph nodes are small, bean-shaped glands that filter harmful substances and help fight infections. They are part of the lymphatic system, a network of vessels that carries a fluid called lymph throughout the body.
The sentinel lymph node is the first lymph node (or group of nodes) to which cancer cells are most likely to spread from the primary tumor. If cancer is found in this node, it may indicate that the cancer has spread to other lymph nodes or parts of the body. If no cancer is found in the sentinel node, it is unlikely that cancer has spread further.
Why is a Sentinel Lymph Node Biopsy Performed?
In the past, patients often underwent full axillary lymph node dissection (removing many lymph nodes) to determine cancer spread. However, this procedure can lead to complications such as lymphedema (swelling of the arm) and limited arm mobility.
The sentinel lymph node biopsy offers a less invasive option that:
Accurately detects whether cancer has spread to the lymph nodes.
Reduces the risk of side effects.
Avoids unnecessary removal of lymph nodes if they are cancer-free.
It is now the standard of care for early-stage breast cancer patients with no obvious signs of lymph node involvement.
How is Sentinel Lymph Node Biopsy Done?
The procedure involves two main steps:
Locating the Sentinel Node
A radioactive tracer and/or a blue dye is injected near the tumor or around the nipple.
These substances travel through the lymphatic system and highlight the sentinel node(s).
Surgeons use a special probe or observe the dye to locate the sentinel node during the surgery.
Removing and Examining the Node
The surgeon makes a small incision (usually near the armpit) and removes the sentinel lymph node(s).
The removed node is then sent to a pathologist, who examines it under a microscope to check for cancer cells.
The entire procedure is often done at the same time as breast cancer surgery (like a lumpectomy or mastectomy).
What Do the Results Mean?
No Cancer Found: If no cancer cells are found in the sentinel node, it is unlikely that the cancer has spread. This often means no further lymph node surgery is needed.
Cancer Found: If cancer is present, further treatment may be recommended, including:
Additional lymph node removal (axillary lymph node dissection).
Radiation therapy to the affected area.
Systemic treatments like chemotherapy, targeted therapy, or hormonal therapy.
Benefits of Sentinel Lymph Node Biopsy
Minimally Invasive: Only a small incision is made, leading to quicker recovery.
Lower Risk of Complications: Reduces the risk of lymphedema compared to full lymph node removal.
Accurate Results: It provides reliable information to guide further treatment.
Possible Risks
While SLNB is generally safe, like any surgery, it carries some risks, including:
Pain or bruising at the biopsy site.
Allergic reaction to the blue dye (rare).
Temporary or mild swelling in the arm.
Lymphedema (less common than in axillary dissection).
These risks are minimal compared to older, more invasive procedures.
Recovery After Sentinel Lymph Node Biopsy
Recovery is typically quick, and most patients resume normal activities within a few days. Patients may experience mild discomfort or swelling, which can be managed with rest, pain medication, and arm exercises as advised by their healthcare team.
Conclusion
Sentinel lymph node biopsy is a significant advancement in breast cancer care. It provides an accurate, less invasive way to assess lymph node involvement, sparing many patients from unnecessary complications. By helping doctors tailor treatment plans, SLNB improves outcomes and quality of life for breast cancer patients.
If you or someone you know is facing breast cancer, discuss with your doctor whether a sentinel lymph node biopsy is right for you. Empowering yourself with knowledge is an important step in your breast cancer journey.
Remember: Early detection and modern treatment options, like sentinel lymph node biopsy, are saving lives every day.
