What Can You Tell Me About Sentinel Node Biopsy?

Question: What can you tell me about sentinel node biopsy? Can I trust the results?

Answer: Sentinel node biopsy, also known as sentinel lymph node dissection, has generated quite a lot of interest in the breast cancer community. It is a somewhat "smarter, kinder, gentler" alternative to axillary lymph node dissection.

Lymph nodes are filters that trap cancer cells (and other unwanted cells) and eliminate them from the body. Pathologists check lymph nodes for cancer cells that have "escaped" from the tumor and are trying to spread.

The presence ("node-positive") or absence ("node-negative") of cancer in the lymph nodes is one of the most important factors your doctor will consider when determining how aggressive your treatment needs to be. Read more about what lymph node involvement means.

In both types of lymph node dissection, lymph nodes are removed from the underarm area next to the breast. A pathologist checks to see if they have cancer cells in them. In sentinel node biopsy, fewer lymph nodes are removed.

Doctors once thought that removing as many lymph nodes as possible would reduce the risk of cancer ever spreading. Until recently, doctors also wanted to remove as many lymph nodes as possible, to get a better idea of how many lymph nodes were affected by cancer. Sentinel node biopsy is changing the way doctors think about this issue.

In sentinel node dissection, the surgeon looks for the "sentinel node," which is the very first lymph node that filters fluid draining away from the breast. If cancer cells are traveling in the lymph system, the sentinel node is more likely than the others to contain the bad guys. So, rather than remove 10 or more nodes, surgeons remove only the one node, or a cluster of two or three, which is most likely to have cancer. If the sentinel node is clean, chances are the other nodes are clean, too.

But it's important to remember that sentinel node biopsy is not appropriate for everyone. It is mostly recommended for women who have early-stage disease, with a relatively low risk of lymph node involvement. Also remember that the procedure is fairly new. So to get the most reliable results, choose a surgeon who has a lot of experience with the technique.

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