Sentinel node biopsy is a simple surgical procedure to determine if cancer has spread from the primary tumour to the lymphatic system.
It is a simple and highly effective technique to know the stage of various types of cancer, but the most common is that it stands used to assess breast cancer or melanoma.
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What is a sentinel lymph node?
It is the node most likely to be the first to which cancer cells spread from the primary tumour. Sometimes there may be more than one sentinel node.
To detect it, we generally use a radioisotope, although it is also possible to do it with a vital dye. The determination of the tracer is done in the operating room. And the detected tissue is sent to the laboratory for its anatomopathological study.
A process of detection, removal and analysis of the sentinel node is known as sentinel lymph node biopsy. Its purpose is to determine whether cancer has spread from the primary tumour to lymph nodes.
Does a positive sentinel node result always indicate metastasis?
It indicates the presence of tumour cells, micrometastasis or macrometastasis, in the sentinel node. Each of these findings has different consequences for the treatment and prognosis of the patient.
Micrometastases occur when the area of spread of the cancer is at least 0.2 mm (or 200 cells) but is not yet more significant than 2 mm. And we speak of macrometastasis when the area of spread is greater than 2 mm. The latter affects the prognosis of cancer since it indicates that it has spread through the lymphatic system.
What happens when cancer stays found in a sentinel node biopsy?
If cancer cells remain found during the sentinel node biopsy, the surgeon may remove other lymph nodes during the same biopsy or in a follow-up surgery.
Sentinel lymph node biopsy may stay done as an outpatient procedure or require a short stay in the hospital. However, the most common is that the sentinel lymph node biopsy remains done simultaneously to remove the primary tumour.
A sentinel node biopsy can performed without tumour resection if we decide to undergo neoadjuvant treatment (before surgery). We must keep the tumour in its location during treatment. However, most often, both procedures done at the same time.
Are there risks to the patient when a sentinel node biopsy stands performed?
There’s no specific risks for actuality subjected to this technique, and none that does not compensate for its performance. It allows obtaining the same advantages as in a classic lymphadenectomy without producing lymphedema or sensory or motor alterations of the upper limb.
The quantity of radioactive material is so small that it remains removed in a few days. This technique is so safe that it can stay performed in pregnant patients with breast cancer.
Can sentinel node biopsy remain performed in patients with breast implants?
It can stay done without problems, although we must continually assess the situation of previous scars so that they do not interfere with lymphatic drainage from the injection site. The puncture can remain done both in the periareolar and peritumoral areas.
Today, a large part of the patients that we operate for cancer have undergone plastic surgery of the breast, and the detection of the sentinel node remains achieved without complications.
In short, sentinel node biopsy is a simple procedure that allows detecting cancer cells in the lymphatic system and thus obtaining an accurate diagnosis to choose the most appropriate treatment for the patient.
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