Reminders and Questions to Ask Your Surgeon

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Other things you'll want to know

  • This is a fairly new surgical approach and should only be performed by an experienced team. One leading surgeon recommends that you look for a physician who has performed at least twenty sentinel node dissections.  
  • Even with an experienced medical team, about 5% of the time no particular sentinel node will take up the dye or tracer during the procedure. It is not a foolproof technique.
  • The procedure is about 10-15% more reliable if both the dye and the radioactive tracer are used, rather than if only one of these two "localizing techniques" is used.
  • When a surgeon puts the dye or tracer directly into the tumor area (not just under the skin), it will drain better into the appropriate axillary lymph nodes. Your surgeon may also massage the breast area after putting in the dye and tracer. Massage improves the chance that the dye and the tracer will be absorbed by the tissues and drain away properly.
  • Undergoing a sentinel lymph node dissection does NOT guarantee that you will not have any side effects of surgery, such as pain, numbness, or lymphedema.
  • The blue dye used in this procedure will stay in your body for quite some time—possibly a few months to a year. You will notice that it looks like a kind of stain under your skin. Some women also notice that their urine is blue immediately after the surgery. This does NOT mean that anything has gone wrong.

The National Surgical Adjuvant Breast Project, sponsored by the National Cancer Institute, is currently studying the best way to evaluate underarm lymph nodes in breast cancer.

Questions to ask your surgeon

  1. Am I a good candidate for sentinel node dissection?
    • Why yes?
    • Why no?
  2. How many sentinel node dissections have you performed?
  3. Will you be using dye AND radioactive tracer? Will it be injected both under the skin or into the tumor region?
  4. How many nodes will you remove—only the sentinel node? Or the cluster that turns blue or concentrates the most tracer?
  5. What are my treatment options if the lymph node shows cancer?

Expert Quote

"You really want to be 100% accurate in terms of whether or not lymph nodes are involved, because that provides the answer to a lot of questions about adjuvant treatment. If you can find the one lymph node that the cancer drains into, you can look at it much more closely than you can look at twenty lymph nodes that you might take out otherwise."

-- Thomas G. Frazier, M.D.

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