Sentinel Lymph Node Biopsy (SLNB)
Introduction
Sentinel nodes are the first few axillary lymph nodes where cancer cells spread into from the main tumour. The biopsy is perfomed to determine if the cancer cells has affected the lymph node. If the no
Breast cancer cells can spread to the nodes in the axilla (armpit) and supraclavicular (neck) area through the lymphatic system. The breast lymphatic system is a collection of vessels (like blood vessels) that passes through the breast tissues to all parts of body. It carries the cancer cells and spread to other parts of the body or node.
What is Sentinel Node Biopsy Procedure?
SLNB procedure involves removing a few (less than 3-5) nodes to determine if the node has cancer cells within it. This is to stage the breast cancer to see if the cancer has spread beyond the breast. A negative SLNB can avoid unnecessary removal of large number of axillary nodes which can lead to the complication of lymphedema*. Lymphedema can also be a complication of SLNB but incidence is less compared to axillary dissection.
The SLNB Procedure
It involves injecting a tracer substance (blue dye) around the tumor or breast tissue during surgery. The tracer substance @ blue dye will travel through the lymphatic system to the first draining (sentinel) nodes. The blue nodes will be identified at surgery by the surgeon and it will be surgically removed through a small incision at the axilla. The SLNB procedure is usually done at the same time as the removal of breast cancer tumor.
SLNB Frozen section
Once the blue node/s has been identified, it will immediately be sent to the pathology lab for frozen section to determine if the node has cancer cells. The result for this procedure will take 30-45mins. During this time, surgery to remove the breast cancer tumor either by mastectomy or lumpectomy will be carried out.
If the frozen section result is negative , no further surgery to the axilla will be carried out and skin incision will be closed.
If the frozen section result in positive, then axillary dissection will be carried out.
Criteria Guidelines for SLNB
Early stage breast cancer with no palpable axillary nodes or abnormal nodes on ultrasound
Ductal Carcinoma-in-situ when mastectomy is performed.
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