A sentinel lymph node biopsy (SLNB) identifies, removes, and examines a sentinel lymph node for the presence of cancer cells. Patients diagnosed with cancer undergo this surgical procedure.
A positive SLNB test indicates the spread of cancer from the sentinel to other regional lymph nodes and possibly other organs. With this information, a doctor can determine the cancer's stage (how far the disease has spread through the body) and develop a treatment plan.
A negative SLNB test result indicates the absence of cancer metastasis to neighboring lymph nodes or other organs.
Lymph node biopsy
Depending on the type of cancer, a sentinel node biopsy may be needed to see if cancer cells have spread to the lymphatic system.
How is it Performed?
During the procedure, you'll most likely be put under general anesthesia. To avoid anesthesia complications, your doctor may advise you to fast for a particular period of time before the procedure.
The tracer/Dye is injected prior to the procedure.
The surgeon starts by creating a tiny incision in the lymph node area. The surgeon uses a small piece of equipment called a gamma detector to evaluate where the radioactivity has gathered and locate the sentinel nodes if you've been given a radioactive solution before the procedure. The blue dye dyes the sentinel nodes bright blue, making them visible to the surgeon. The surgeon next removes the sentinel nodes. One to five sentinel nodes are usually present, and they are all removed. Using a microscope, a pathologist examines the sentinel nodes for cancer cells.
The location of the sentinel nodes is the initial step in doing a sentinel node biopsy. The following are some of the alternatives:
- A mild radioactive solution is injected near the tumor during this treatment. This solution is absorbed by your lymphatic system and transported to the sentinel nodes.
- This injection is usually given several hours, if not a day, before the surgical surgery to remove the sentinel nodes.
- Methylene blue / ICG dye that can be used to create a variety of colors. Your doctor may inject a non-toxic blue dye into the area surrounding the tumor. The dye is sent to the sentinel nodes through the lymphatic system, turning them a vibrant blue color.
- At the injection site, you may notice a change in your skin color. This color usually fades with time, although it could be permanent. You may also notice that your urine turns blue for a short period of time.
- The blue dye is usually delivered shortly before the surgical procedure to remove the sentinel nodes.
- Your surgeon will choose whether you receive the radioactive solution, blue dye, or both to find the sentinel nodes. During the same operation, some surgeons combine the two treatments.
Your first follow-up appointment will be arranged based on the type of surgery you had and how well you recovered. Depending on where you reside and what the medical team recommends, you may see the surgeon or your primary care physician. Your doctor will evaluate your wound and remove any stitches, staples, glue, or drains that are still in place.
In general, sentinel node biopsy is a generally safe procedure. However, like with any surgery, there is the risk of complications, which include the following:
- Bruising or soreness at the location of the biopsy
- Allergic reaction to the dye used in the technique
- Lymphedema: A condition in which the lymph veins in a particular part of the body don't work properly, causing fluid to build up and swelling
You'll then be sent to a recovery room, where your medical team will monitor you for any complications from the therapy or anesthesia. You will be able to go home on the same day if no additional surgery is required. Depending on your circumstances, you will be able to resume your typical activities sooner or later. The intricacy of the operation will determine the length of your hospital stay if a sentinel node biopsy is performed as part of the treatment to remove the cancer.