When breast cancer is diagnosed, your doctor’s first priority is to determine if the cancer has spread beyond the breast. To understand how far your cancer has spread, your doctor will perform a sentinel lymph node biopsy. By checking your sentinel lymph nodes, your surgeons and oncologists can determine the stage of your cancer and use it as a guide for your treatment options.
What Is a Sentinel Lymph Node Biopsy?
A sentinel lymph node biopsy is a procedure where one to three sentinel nodes are removed and examined under a microscope to see if cancer has spread beyond the breast. Due to the location of your sentinel lymph nodes, they are the most likely to show cancer cells first if your breast cancer has spread. If no cancer cells are detected during the biopsy, it is unlikely that the remaining lymph nodes are affected.
Sentinel lymph node biopsies (SLNB) are a less invasive surgery since they only require a few lymph nodes to be removed for testing. Recovery following a SLNB commonly allows patients to benefit from fewer complications, less discomfort, and a faster recovery while still receiving accurate information about the stage of their breast cancer.
Why Is It Important in Breast Cancer Staging?
Results from an SLNB drive the cancer staging process, allowing your doctors to develop treatment plans and estimate outcomes. If an SLNB comes back clear, patients have a more favorable outlook than those with cancer-positive nodes. By having additional information on how far cancer has progressed, doctors can help prevent patients from going through unnecessary radiation or surgery.
Benefits of Sentinel Lymph Node Biopsy
Over time, sentinel lymph node biopsies have become the standard in breast cancer surgery because of a number of benefits they offer over other methods, including:
- Faster Recovery: Minimally invasive procedures, such as SLNB, allow patients to get out of the hospital earlier with less discomfort.
- Lower Complication Risk: Patients have reduced risk of common side effects such as pain, lymphedema, numbness, and limited shoulder mobility.
- High Accuracy: Surgeons are able to get the test results they need from a less invasive surgery without unnecessary surgical risks.
Although breast cancer treatment can be stressful, the benefits of a sentinel lymph node biopsy can help preserve a patient’s quality of life throughout treatment without sacrificing the effectiveness of care.
How SLNB Influences Treatment Decisions
Sentinel lymph node biopsies allow your doctor to personalize your cancer treatment. When SLNB results are negative, doctors can forgo additional lymph node surgeries. It is also common that patients with negative results will not need treatment methods that are more aggressive on the body.
For patients with positive results, doctors may recommend further lymph node removal to determine how far the cancer has spread. Additional treatment methods such as chemotherapy, radiation, or surgery may be necessary to fight against later-stage cancers.
Breast cancer does not behave the same in every person, and sentinel lymph node biopsies help build the bridge between your initial diagnosis and your treatment plan.
Who is a Candidate for Sentinel Lymph Node Biopsy?
Sentinel lymph node biopsy is commonly recommended for patients with early-stage breast cancer, but it is not the right option for everyone. The decision depends on the type and stage of the cancer, as well as the patient’s medical history.
Who Typically Benefits from SLNB
- Patients with early-stage invasive breast cancer: SLNB is most often recommended for patients whose tumors are small and confined to the breast, with no clinical signs of lymph node involvement.
- Patients undergoing lumpectomy or mastectomy: Whether you’re having breast-conserving surgery (lumpectomy) or a mastectomy, SLNB may be performed at the same time to check for cancer spread.
- Patients with ductal carcinoma in situ (DCIS) undergoing mastectomy: While DCIS is considered non-invasive, if a mastectomy is planned, an SLNB is sometimes recommended. This is because if invasive cancer is found in the removed tissue, lymph nodes can no longer be checked later without a second surgery.
When SLNB May Not Be Appropriate
- Inflammatory breast cancer: This aggressive cancer almost always involves multiple lymph nodes, so a more extensive evaluation is usually needed.
- Patients with known advanced disease: If scans or exams already show significant lymph node involvement, SLNB is unnecessary, since more comprehensive treatment is required.
- Previous lymph node surgery or radiation: Prior procedures may alter lymphatic drainage, making it harder to accurately identify the sentinel node.
For many patients, SLNB is the preferred method because it balances accuracy in staging with fewer side effects. However, the best approach is always determined by a breast surgeon in consultation with the oncology team, taking into account the patient’s unique diagnosis and overall health.
The Procedure: What Patients Can Expect
For many patients, the idea of surgery can feel overwhelming. Understanding what happens during a sentinel lymph node biopsy can help reduce anxiety and prepare you for the experience.
Step 1: Preparation
Before surgery, the surgeon injects a small amount of blue dye, a radioactive tracer, or both near the tumor site. These substances travel through the lymphatic system and highlight the sentinel lymph nodes.
Step 2: Locating the Sentinel Nodes
The surgeon uses special instruments to follow the dye or tracer to the sentinel lymph nodes, usually one to three nodes located under the arm.
Step 3: Removal of Nodes
Through a small incision, the surgeon removes the identified nodes. These are sent to the pathology lab, where they are examined for cancer cells under a microscope.
Step 4: Recovery
Most patients return home the same day. Some may experience mild soreness, temporary swelling, or slight bruising at the incision site. These side effects usually improve within a few days to weeks.
Possible Side Effects
Although SLNB is considered safe, some patients may notice:
- Mild discomfort or numbness in the underarm
- Temporary changes in skin color from the dye
- In rare cases, mild swelling of the arm
Because fewer lymph nodes are removed, recovery is typically quicker and the risk of long-term complications is much lower than with more extensive lymph node surgery.
Sentinel Lymph Node Biopsy at The Surgical Clinic
At The Surgical Clinic, our surgeons are committed to providing expert, patient-focused care for individuals facing breast cancer. Sentinel lymph node biopsy is one of the many advanced procedures we use to stage breast cancer accurately while reducing risks and supporting faster recovery.
If you or a loved one has been diagnosed with breast cancer, understanding your options is the first step toward effective treatment. Schedule a consultation with The Surgical Clinic today to learn how sentinel lymph node biopsy and our comprehensive breast cancer care can help guide the best possible outcome.
Frequently Asked Questions
Does SLNB hurt?
The biopsy is performed under anesthesia, so patients do not feel pain during surgery. Some mild soreness or tenderness may occur afterward, but this is usually manageable with over-the-counter pain medication.
What are the risks of lymphedema?
Because only a few nodes are removed, the risk of lymphedema (swelling of the arm) is much lower compared to a full axillary lymph node dissection. While the risk is not zero, most patients never experience this complication.
Can SLNB miss cancer spread?
The biopsy is highly accurate, but like all medical tests, it is not perfect. In rare cases, cancer may bypass the sentinel nodes. Surgeons minimize this risk by using both dye and tracer methods to increase accuracy.
How soon are results available?
In many cases, a pathologist provides initial results during surgery. More detailed testing may take several days. Your surgeon will explain the findings and next steps once the results are complete.
Are sentinel lymph node biopsies safe?
Yes. SLNB is considered a safe and routine procedure with low complication rates. The benefits of accurate staging far outweigh the small risks.