The Marvels Of The Sentinel Node Biopsy

What is a Lymph Node?

Lymph nodes are small round organs that are part of the body’s lymphatic system, and an important part of the immune system.  Lymph nodes are found throughout the body and are connected to one another by lymph vessels.

Groups of lymph nodes are located in the neck, underarms, chest, abdomen and groin.  A clear fluid called lymph flows through the vessels and nodes.

Lymphatic cells monitor lymphatic fluid for the presence of “foreign” substances, such as bacteria and viruses. If a foreign substance is detected, some of the cells will become activated and an immune response will be triggered.  You can think of your lymphatic system as the garbage collectors of your body.

The lymphatic system is studied in breast cancer patients because cancer cells can be spread via lymph nodes, making it a factor in cancer metastasis (spread).  Back in the bad old days, for instance when my grandmother was going through breast cancer, it was just assumed that the cancer had spread to the lymphatic system and the standard practice was to remove a woman’s breast and all of the lymph nodes in the armpit and arm on the affected side, generally leaving a woman with no way for the cells of that arm to discharge their waste, leading to swelling, pain and discomfort, called lymphedema.

The Sentinel Node

The sentinel node is defined as the first lymph node to which cancer cells are most likely to spread from a primary tumor.  Sometimes there can be more than one sentinel lymph node.

Sentinel Node Biopsy

A sentinel node biopsy is a procedure in which the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present.  Here is how the process works:

  1. A radioactive substance, a blue dye, or both, is injected near the tumor to locate the position of the sentinel lymph node. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, the surgeon makes a small incision (about 1/2 inch) in the overlying skin and removes the node – sometimes several are removed for examination.
  2. The sentinel node is then checked for the presence of cancer cells by a pathologist.  If cancer is found, the surgeon may remove additional lymph nodes, either during the same biopsy procedure or during a follow-up surgical procedure. The procedure may be done on an outpatient basis or may require a short stay in the hospital.
  3. Sentinel node biopsy is usually done at the same time the primary tumor is removed. However, the procedure can also be done either before or after removal of the tumor.

I had this procedure myself and I am SO GLAD I didn’t have to lose any more than three lymph nodes.  This procedure is a giant leap forward and I’m thankful for the doctors who developed it.  It was a new surgical procedure, still being tested, when I had it in 2004.  These days, it is much more routinely performed.

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