When breast cancer spreads, it usually first travels to the lymph nodes in the axilla (armpit). Lymph nodes are small bean shaped organs that form an important part of the body’s immune system. Sentinal lymph node is the first lymph node to which the cancer cells most likely spread from a primary tumour. These sentinel lymph nodes are the first to drain the lymphatic fluid from the breast, thereby spreading cancer if it is contained in the fluid.
Sentinel lymph node biopsy is a diagnostic procedure used for detecting, removing and examining to determine whether the cancer cells are present in the lymph node. For patient-centered care to improve quality of life and overall health outcomes, most people come to HMS Mirdif Cancer Center in Dubai as our board-certified doctors use the latest technology and information management protocols to provide suitable lymph node localization to all the patients.
What is Sentinal Lymph Node Biopsy?
In sentinal lymph node biopsy procedure, sentinal lymph nodes are identified, removed, and sent for pathological examination to detect the presence of cancer cells. It is thought that if the breast cancer cells escape into the lymphatic system, they first travel to the sentinal nodes before moving on to the other nodes. Sentinel lymph node (SLN) technique is based upon the study that tumour cells migrating from a primary tumour invade one or a few lymph nodes before involving other lymph nodes.
It is a minimally invasive technique and is a proven, reliable, and accurate alternative treatment modality for breast cancer patients. In the biopsy, the surgeon removes only a few (1-5) sentinel lymph nodes. Dissection of the sentinal nodes reduces the chances of any sort of complications and in most cases provides the necessary information about cancer. If the sentinel nodes are free of cancer, it is assumed that the remaining nodes are also clear and no further lymph nodes are then removed.
What are Lymph Glands or Nodes?
The human body consists of the lymphatic system – a structure of lymph vessels and lymph glands. They all together play a vital role in the body’s mechanism to fight off infections and tumors. Tiny channels carry fluid and debris to the lymph nodes or glands, which act as filters.
Groups of lymph nodes are located in the neck, underarms, chest, abdomen, and groin. The lymph nodes that filter waste fluid and cells from the breast are primarily located in the armpit also known as axilla. They are the first ones to get affected if in case cancer spreads beyond the breast. The number of lymph nodes in the axilla varies from person to person but usually ranges from around 20 to 40.
How Are Sentinal Lymph Nodes Identified?
Sentinal lymph node imaging is a sophisticated lymphatic mapping that is usually performed the day before or on the day of surgery. A small amount of radioactive substance is injected into the breast that flows through the lymphatic ducts. Lymphoscintigraphy is used to find the sentinel lymph nodes which are then removed and checked for tumour cells.
Under general anaesthesia, a Blue Dye Injection is injected into the breast. The dye then flows through the lymphatic ducts to the lymph nodes. The first lymph nodes to receive the dye are removed and viewed under the microscope to detect the cancer cells. The lymph nodes are not removed if the cancer cells are not found.
Intraoperative gamma probe detection used in the operating room directs the surgeon to the radioactive isotope injected several hours before the surgery. The radioactive sentinel nodes are removed by the surgeon and investigated for cancer cells. Not necessarily all the lymph nodes that are mapped contain cancer cells.
When Is Sentinal Biopsy Conducted?
The sentinal biopsy is usually performed along with breast surgeries. In rare instances, it is done as a separate procedure before mastectomy when immediate reconstruction is preferred. Based on the status of the sentinel nodes, one can decide about the post-surgery radiation which in turn influences reconstruction decision.
What Is Meant By False Negative Result
In some patients, the cancer cells are not seen in the sentinel lymph nodes although they are present and may have already spread to other regional lymph nodes or other parts of the body. A false-negative biopsy result gives the patient and the doctor a false sense of security about the extent of cancer in the patient’s body.
Once you know the exact problem in the lymph nodes, a suitable lymph node localization treatment will be planned and implemented. At HMS Mirdif Cancer Center in Dubai, we apply technological advances to transform cancer treatment. We have expert breast cancer surgeons who offer a comprehensive range of breast cancer surgeries, including oncoplastic surgeries, sentinel lymphnode biopsies with dual tracer marking and hook wire localisations and more.
Contact us to book your appointment.