Download Sentinel Lymph Node Biopsy

Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy is the removal and testing of specific lymph node tissue.
A sentinel lymph node biopsy is often done during cancer-removal surgery. The sentinal
nodes are the lymph nodes that are associated with the area where the cancer was
removed. Sentinel node biopsy is part of the staging process. Staging is an attempt to
determine if cancer has spread away from the original tumor.
Reasons for Procedure
This biopsy is done to determine if cancer cells have spread from the tumor to nearby lymph
nodes. Cancer often spreads from the tumor to the nearest lymph node or nodes. These
lymph nodes are called the sentinal nodes. It is important to understand that the sentinel
node will probably be the first one to get cancer if the cancer has spread. In the case of
breast cancer, the sentinal nodes are often found in the armpit.
Possible Complications
Complications are rare but no procedure is completely free of risk. If you are planning to
have this biopsy, your doctor will review a list of possible complications which may include:
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Infection
Bleeding or bruising
Scarring
If the lymph nodes are removed, there is an increased risk of the following:
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Delayed wound healing
Additional pain
Lymphedema, a condition in which fluids collects in the tissues
Some factors that may increase the risk of complications include:
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Obesity
Recent of long-term illness
Smoking
Poor nutrition
Use of certain medications
Bleeding disorders
What to Expect
Prior to Procedure
Your doctor will do a physical exam. The cancerous tissue will be biopsied. Tests may
include the following:
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Blood tests
Urine tests
A mammogram, in cases of breast cancer
Talk to your doctor about your medicines. You may be asked to stop taking some medicines
up to one week before the procedure like:
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Aspirin or other anti-inflammatory drugs
Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
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The night before, eat a light meal. Do not eat or drink anything after midnight.
Arrange for a ride to and from the hospital.
Anesthesia
Depending on the location of the lymph node you may be given one of the following:
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General anesthesia—you will be asleep
Local anesthesia—the area will be numb
Regional anesthesia—lower body will be numbed
Description of the Procedure
A sentinel lymph node biopsy is usually done during cancer-removal surgery.
A blue dye and often a radioactive tracer will be injected in the area where the tumor is. It
may be done several hours before surgery. The dye and tracer will travel from the tumor
area to the sentinal nodes. This will help identify which nodes are the sentinel lymph nodes.
The surgeon will make a small incision. The sentinel node (or nodes) will be removed. The
removed node will be checked for cancer cells. If cancer is found, the surgeon will remove
the rest of the lymph nodes in that area. The lymph nodes may also be taken out if the
sentinel lymph node cannot be located.
If cancer is not seen in the sentinel node, it is unlikely that the cancer has spread to the
lymph nodes. The other lymph nodes are not removed.
How Long Will It Take?
The biopsy takes about 30-60 minutes. This entire cancer removal surgery takes longer.
Will It Hurt?
Anesthesia prevents pain during surgery. Pain medications are given during recovery.
Post-procedure Care
Be sure to follow your doctor's instructions. Keep the surgical area clean and dry.
The result of the sentinel lymph node biopsy determines if additional lymph nodes need to
be removed. It can also help determine the severity of your cancer.
If you've had lymph nodes removed from your armpit, your arm is at risk of fluid
accumulation and swelling (lymphedema) and/or serious infection (lymphangitis). These
complications are more common in patients who have had an axillary dissection than in
those who have had sentinel node biopsy. If you do develop complications from lymph node
surgery, you'll need to take some special precautions:
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Don't have blood pressure taken, blood drawn, or shots given in that arm.
Wear gloves to do dishes, household scrubbing, and yard work.
Don't wear anything tight on that arm, including elastic in sleeves.
Don't carry heavy packages, purses, suitcases, grocery bags, etc. with that arm.
Keep the skin of that arm well-moisturized with a lanolin-containing product.
Use an electric shaver if you wish to shave your armpits.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
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Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision
site
If lymph nodes were removed: redness, warmth, swelling, stiffness, or hardness in
the extremity
Fingers and toes should always be warm and pink. Call your doctor if they become
dusky or swollen.
Nausea and/or vomiting that you can't control with the medications you were given
after surgery, or which persist for more than two days after discharge from the
hospital.
Pain that you can't control with the medications you've been given.
Cough, shortness of breath, or chest pain.
New, unexplained symptoms