What Is Sentinel Node Biopsy?

Sentinel Node Biopsy is a diagnostic procedure to determine if cancer has spread beyond the primary tum or site to the lymphatic system and other parts of the body. The procedure involves surgical removal of the "sentinel" lymph node(s), and pathologic analysis of the lymph node to determine if it contains cancer cells.

The spread of malignant cells to the lymph nodes is one of the main indicators of the spread of cancer and helps doctors determine the type of treatment that should follow: further surgery, radiation, chemotherapy or a combination of the three. If the lymph nodes are negative, sometimes no further treatment is necessary.

How is Sentinel Node Biopsy performed?

Before the procedure, the patient is injected with a small dose of a radioactive agent (less radioactivity than that of an x-ray) and a blue dye. The drug and the dye travel from the tumor site to the sentinel node just as a cancer cell might. Nuclear Medicine imaging, or lymphos-cintigraphy, may be performed prior to the patient's surgery.

In the operating room, using the Navigator* System's small hand-held probe, the surgeon scans the suspected area. When the probe detects the radioactive agent, it emits an audible tone, signaling the precise location of the sentinel node and the exact location for the small surgical incision. The blue dye provides a visual aid to the doctor, confirming the node's location.

Guided by the Navigator*, the surgeon removes the sentinel node through a small (1-2 inch) incision. The sentinel node is then examined by a Pathologist to determine if cancer has spread to the lymphatic system. Clinical studies have shown that in 98% of cases, if the sentinel node is cancer-free, then the cancer has not spread.

What is the benefit of Sentinel Node Biopsy?

Traditional treatment for many cancer patients, including those with breast or skin cancer, calls for an invasive procedure that involves a large 4-6-inch incision (usually underneath the arm for breast cancer patients) and removal of 10 to 30 lymph nodes. Although the procedure provides surgeons with critical cancer-staging information and helps determine the chance of recurrence, it can cause significant post-operative pain, nerve damage, chronic swelling and other complications. Many surgeons agree, however, that accurate staging information can be gained simply by removing the first node in a lymphatic chain-the "sentinel" node. By only removing the sentinel lymph node(s) rather than all the regional lymph nodes, many of the complications associated with a full lymph node dissection may be avoided, and the procedure is much less invasive.

What if cancer is found in my sentinel node?

If your surgeon gets a positive (cancerous) pathology report while you are still on the operating table, you may have all of the lymph nodes in the area of the tumor removed, not just the sentinel node. If the pathology report is not available immediately, a follow-up visit with your surgeon to review the pathology results and discuss treatment options will be scheduled.

How long will I be in the hospital?

Usually no more than a day. Depending on your surgical plan, the procedure may also be done on an outpatient basis. Your doctor can explain the option that is best for you.

Am I a candidate for A Sentinel Node Biopsy procedure?

Not every patient with your diagnosis is a candidate for this procedure. Your primary care physician and your surgeon can determine with you if this is your best surgical option.