Sentinel Lymph Node Biopsy

What is a Sentinel Lymph Node Biopsy?

A sentinel lymph node biopsy is a diagnostic surgical procedure performed to determine whether cancer has spread into the lymphatic system from its original site. The sentinel node is the first node to which the cancer spreads after leaving its site of origin.

Reasons for a Sentinel Lymph Node Biopsy

A sentinel lymph node biopsy can be used to diagnose the spread of the following cancers:

Breast cancer
Melanoma
Head and neck cancer
Thyroid cancer
Non-small cell lung cancer
Stomach cancer
Colon cancer
Vulvar cancer
Endometrial cancer
Cervical cancer

In the case of breast cancer, the sentinel node is located under the arm and is the first node that drains fluid from the breasts. Because of its position, many doctors believe that, if cancer spreads beyond the breast, the sentinel node is the first place it would appear, and that, if there are no cancerous cells in the sentinel node, the cancer has likely not spread beyond the breast.

Lymph Node Dissection

Lymph node dissection is a surgical procedure in which lymph nodes are removed from the armpit or groin area to check whether a cancer has spread from its original site to an adjacent area. Since cancer often spreads to the nearby lymph nodes before it spreads to anywhere else in the body, the lymph node dissection can show whether the malignancy has traveled from its original site. Cancers that have a marked tendency to move to the lymph nodes include melanoma, head and neck cancers, colorectal cancer, gastric cancer, and cancers of the breast, thyroid and lung.

Lymph Node Dissection Procedure

Lymph node dissection takes about one hour, and is usually performed under general anesthesia. An incision, no longer than three inches wide, is made in the armpit or groin and a group of lymph nodes are removed for tissue analysis. The incision is then closed with stitches, and a bandage is placed over the incision site. Tissue from the lymph nodes is sent to the lab for further analysis and a full pathology report is usually available a few days later.

Risks of Lymph Node Dissection

While lymph node dissection is a safe procedure, there are risks associated with any surgical procedure. These may include:

Excessive bleeding
Allergic reaction to anesthesia
Tingling, numbness or weakness of the arm or leg
Loss of sensation in the armpit or groin
Development of deep vein thrombosis (DVT)
Infection at the site of the incision

Signs of infection, including the following, require immediate medical intervention, usually the administration of antibiotics.

Fever (temperature greater than 101 degrees Fahrenheit)
Severe pain or pain that lasts more than 48 hours
Oozing at the incision site

Recovery from Lymph Node Dissection

Patients return home the day of the procedure and most regular activities can be resumed the next day. The patient may experience tenderness and swelling at the incision site, but this usually dissipates after a few weeks. It is important to follow medical instructions for proper healing, which include: