Doctors perform the surgical procedure of sentinel node biopsy for cancer patients. It is also known as SLNB or sentinel lymph node biopsy. At the time of the surgery, doctors cut out the sentinel lymph nodes present in the body of the patient.
Later, they send the specimen to the lab for testing the presence of cancer cells. Around 34% of the cases are diagnosed as malignant and 45% of the cases as benign, as one report shows. This count can fluctuate.
Why it’s done?
Generally, the sentinel node biopsy works for cancer patients to evaluate where the cancer cells are present. It also helps doctors determine the extent of cancer based on how much of the lymphatic system is affected.
This procedure is suitable for particular cancer types, like:
- Breast cancer
Specialists are testing the procedure currently to see if it works with other cancer types. These cancer types include:
- Head and neck cancer
- Stomach cancer
- Colon cancer
- Thyroid cancer
- Non-small cell lung cancer
- Esophageal cancer
Why is sentinel node biopsy important?
Cancer patients get this procedure for the examination and diagnosis of cancer cells in the lymph nodes. Here, oncologists check if the cancer cells have expanded into this system or are almost on the verge of spreading. Generally, this surgery is a secondary step since patients already have a tumor at this point.
If the test shows no affected lymph nodes, oncologists can avoid the process of cutting out multiple lymph nodes. This reduces the potential of lymphedema in cancer patients. This condition is a common risk of this procedure, especially if surgeons remove multiple lymph nodes altogether.
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How you prepare?
Before the surgical procedure, a breast cancer doctor would advise you not to drink or eat for a specific period. This is important for reducing the chances of complications from anesthesia usage. Here, doctors would give instructions on the preparation points as per your condition.
What you can expect
During this surgical procedure, surgeons locate the sentinel lymph node(s) using a blue dye or radioactive substance. In some cancers, oncologists suggest both. Later, the surgeon in charge uses a particular tool to view the stain of the substances on the lymph nodes.
After locating the sentinel nodes, surgeons make a 1/2 inch incision at the site and cut the sentinel lymph nodes out. They send the sample to the path lab where professionals check for the cancer cells.
In case the test comes out as positive, surgeons can remove the nodes at the time or in the follow-surgery. Patients may have to stay at the hospital for a while. But, most cancer patients getting this arrive for the outpatient service.
In most cases, this procedure occurs alongside primary cancer removal.
Typically, sentinel node biopsy is safe to complete but can come with particular risks. These include:
- Swelling or fluid build due to lymphedema
- Bruise or pain present at the site of the biopsy
- Allergy to the blue dye substance
In case the surgery and the subsequent testing shows no signs of cancer, doctors can skip further testing.
If the testing shows that at least one of the sentinel nodes has cancer presence, doctors would conduct a removal process. In certain cases, the pathologist checks the sentinel nodes directly at the time of the initial procedure.
How accurate is sentinel node biopsy?
In most cases, the accuracy of the sentinel node biopsy is very high. In one study, experts compared SLNB-related factors compared to ALND.
The value for specificity and sensitivity came as 87.5% and 92% respectively. Also, false negatives among the multiple cancer patients in this study are low; e.g., 8%. Overall, the accuracy rate of SLNB is 90.9% approximately.
What happens after sentinel node biopsy?
After the surgery completes, you would notice soreness at the incision site. The doctor in charge can prescribe pain medication, or you can use OTC pain medication. For some days, the area would feel tender. In case the sentinel node was under the arm, moving your limbs would feel stiff.
Talk to your doctor about when you can resume normal activities. Generally, the no-physical-stress period lasts for some weeks for patients. Also, patients should keep the incision area clean.
How long does it take to recover from the surgery?
The recovery time for SLNB surgery varies from patient to patient. How extensive the primary cancer surgery was, and the size of the tumor matters here. Although, compared to axillary lymph node dissection, this procedure takes less time to heal.
Overall, sentinel node biopsy is an effective process for diagnosing and removing cancerous sentinel lymph nodes. The process is useful for further evaluation of treatment plans and the recovery time is low. For further detail on the recovery process, consult with your doctor.
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