Sentinel Lymph Node Biopsy

What is Sentinel Lymph Node?

  • Sentinel lymph node is the first lymph node that drains the lymphatics from the cancer.

What is Sentinel Lymph Node Biopsy?

  • Sentinel Lymph Node Biopsy is a procedure in which the sentinel lymph node is identified and sent for biopsy.

For whom and why is Sentinel Lymph node Biopsy done?

  • One of the first questions that a patient asks the doctor when she has breast cancer is “How much has the cancer spread? ”When the cancer has not been found to have spread to the other parts of the body by clinical and as well as by investigations, Sentinel Lymph Node biopsy is done. By taking a biopsy of that node and testing whether it is affected by cancer one can know whether the cancer has spread

How is Sentinel Lymph Node Biopsy done?

  • The Figure above shows the first lymph node draining the tumour in the axilla called Sentinel Lymph Node Biopsy

Why do we do Sentinel Lymph Node Biopsy? Can’t we just do axillary dissection for all the patients?

  • Sentinel Lymph Node Biopsy helps us to avoid the complications associated with Axillary Lymph Node Dissection like lymphoedema, seroma and haematoma.

How effective is Sentinel Lymph Node Biopsy done?

  • Combining both Methylene blue and ICG(Indocyanine Green) to detect Sentinel Lymph Node Biopsy helps us to detect 99.5% of spread to the axillary lymph node*.
  • Guo Jetal. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye,and their combination in breast cancerpatients: a prospective cohort study.World Journal of Surgical Oncology (2017) 15:196.

If the Sentinel Lymph node Biopsy is positive what is the next step?

  • If the Sentinel Lymph node is positive, that means there has been spread to the axilla and the axilla has to be cleared of tumour by axillary lymph node dissection.

If the Sentinel Lymph node Biopsy is negative what is the next step?

  • If the sentinel Lymph node biopsy is negative, it means that there has been no spread to the axilla & axillary lymph node dissection need not be done.