SENTINEL NODE BIOPSY

Sentinel node biopsy involves removal of a few nodes (usually 1 to 3 nodes). It is the standard technique to assess the lymph nodes in women with early breast cancer. The sentinel node is the first lymph node into which fluid from the breast drains, and is therefore the first place to which breast cancer can spread. If the sentinel nodes are clear of cancer cells, no further surgery is needed. If one or more sentinel nodes contain cancer cells, axillary dissection or radiotherapy to the armpit may be required. 

To work out the which lymph nodes are the sentinel nodes, you will have the following procedures.

This is done either the day before or on the morning before your operation. A small amount of a radioactive substance is injected into the breast. A scan is taken to show which nodes the substance flows to first. These are likely to be the sentinel nodes.

The operation is performed under a general anaesthetic. Blue dye is injected into the breast. The dye moves into the lymphatic vessels and stains the sentinel nodes blue first. Because of the dye, you will have bluish urine the next day and may have a blue patch on the breast for some weeks.

As well as looking at where the blue dye travels to first, a handheld probe is used during the operation to detect the radioactive substance that was injected during the lymphatic mapping. This helps to confirm that the correct sentinel nodes have been identified and they can then remove them for testing.

All surgery has risks despite the highest standard of practice. The following possible complications are listed to inform not to alarm. There may be other complications that are not listed.

• Bleeding
• Infection
• Seroma, a build-up of fluid in the cavity where the tissue has been removed. Sometimes it can cause a swelling and the fluid may need to be removed with a needle and syringe.
• Scarring
• Allergic reaction to the blue dye, ranging from mild to severe.
• Numbness in the armpit, upper arm and shoulder area
• Shoulder stiffness
• Lymphoedema



Dr Mary Ling performs breast cancer surgery at Gosford Private Hospital and Brisbane Waters Private Hospital on the Central Coast. Dr Ling welcomes patients from Newcastle, Lake Macquarie, the Hunter Region and Northern NSW. Dr Ling participates in the No Gap scheme for cancer operations if you have private insurance.