In less than 5% of cases sentinel node biopsy does not accurately find disease within the armpit. What are the disadvantages of sentinel node biopsy? It is a smaller operation than the alternative Axillary Node Clearance (where all the armpit nodes are removed) and recovery time is usually quicker, less painful and the risk of long term arm swelling is significantly lower. Sentinel node biopsy is a 95% accurate way of determining the stage of your disease. What is the advantage of sentinel node biopsy? Your surgeon will remove any lymph nodes that are radioactive or blue in colour. A hand held gamma probe used in the Operating Theatre guides your surgeon to the radioactive material injected previously. If you are having a mastectomy, your surgeon will be able to reach the sentinel nodes through the mastectomy scar, so you won’t have an extra scar in your armpit. The surgeryĪ small cut is made in your armpit if you are having breast preserving surgery. This dye stains the sentinel node blue so that it helps your surgeon to find the correct lymph node. This is injected once you are asleep in theatre at the beginning of your operation. This radioactive material is carried into your armpit by the lymph vessels and trapped in the sentinel node. On the morning of your operation (or occasionally the day before) a small amount of radioactive material called Technetium is injected into your breast. We use a combination of 2 methods to identify the sentinel lymph nodes: Isotope Injection How do you identify the sentinel lymph node? Problems such as pain, numbness, lymphoedema (long term fluid swelling) and shoulder stiffness can be more common following an Axillary Node Clearance. The main alternative is to have the majority of the nodes removed from your armpit in an operation called Axillary Node Clearance. What are the alternatives to this operation?Ī Sentinel Node Biopsy is not a treatment for breast cancer it is done to gain more information. This treatment may involve further surgery, radiotherapy, hormone treatment, chemotherapy or a combination of these treatments. Very important decisions regarding the overall treatment of your breast cancer are made, based on whether the lymph glands contain tumour cells. Why is it so important to know whether tumour cells are present in the lymph nodes in the arm pit? Out of these there are 1 to 4 lymph nodes into which all the lymph fluid from the breast will first drain. The number of lymph nodes in your armpit can vary. The lymph glands responsible for the breast lie mainly within your armpit, but occasionally may be within your chest or neck. The lymphatic system is a system of lymph vessels and lymph glands throughout the body which play an important role in fighting infections and tumours. Several large research studies have shown the benefit of sentinel node biopsy and it is now the standard treatment for early breast cancers where the pre-operative ultrasound scan of the axilla shows no obvious signs of cancer. This lymph node is then looked at in under a microscope to see whether there are tumour cells in it. Sentinel node biopsy is an operation to remove the first lymph nodes in your armpit (axilla) that are responsible for draining the area of your breast involved by a breast cancer. Breast Care Patient Information Leaflets.Clinical Nurse Specialist Four Week Follow Up Clinic.Clinical Nurse Specialist Clinic (Nurse Led Results Clinic).Change/Request Your Breast Screening Appointment.These nodes will remain marked in this way for many weeks, allowing a pathologist to look at the DCIS tissue removed from your breast and accurately determine if you would benefit from having those marked lymph nodes removed. The Magtrace® lymphatic tracer allows your surgeon to mark the sentinel lymph nodes (the first nodes cancer would migrate to if present) in advance or on the day of your surgery. A delayed sentinel lymph node biopsy ensures that the only patients who undergo SLNB surgery are those who actually need their nodes removed. However, because there is a small chance that there may be invasive disease, traditional methods have meant all patients receiving a mastectomy to remove their DCIS will also be given a SLNB regardless of whether they need it or not.įortunately, new medical developments mean that there is now an alternative treatment. The challenge with treating patients with DCIS is determining whether you have non-invasive DCIS, or whether it has developed in to a more invasive cancer.įor patients with DCIS alone, a SLNB is an unnecessary procedure, as cancer won’t have spread beyond the milk duct.
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