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sentinel LN biopsy in breast cancer - Coggle Diagram
sentinel LN biopsy in breast cancer
Indications
For patients with early-stage breast cancer (T1-T2, N0-N1) who are candidates for breast-conserving surgery (lumpectomy) or mastectomy.
SLNB may also be considered for patients with larger tumors (T3-T4) who are not candidates for ALND due to medical reasons or patient preference.
Technique
Preoperative preparation: The patient is asked to fast for several hours before the procedure. The surgeon marks the location of the tumor and injects a small amount of radioactive tracer and blue dye around the tumor site. The tracer and dye travel through the lymphatic system to the sentinel node, which is the first lymph node that drains from the tumor site.
Anesthesia: The patient is given local anesthesia to numb the area where the biopsy will be performed. In some cases, general anesthesia may be used.
Surgery: The surgeon makes a small incision near the tumor site and uses a handheld gamma probe to locate the radioactive tracer. The blue dye helps to identify the sentinel node, which is removed and examined for cancer cells. Additional lymph nodes may be removed if necessary.
Pathology: The sentinel node is sent to the pathology lab for examination. If the sentinel node is cancer-free, it is likely that the remaining lymph nodes are also cancer-free, and further lymph node dissection may not be necessary.
Closure: The incision is closed with sutures or surgical glue. The patient is monitored in the recovery room for several hours before being discharged.
The sentinel node is identified using a radioactive tracer and a blue dye, which are injected around the tumor site before surgery. The tracer and dye travel through the lymphatic system to the sentinel node, which is then removed and examined for cancer cells. If the sentinel node is cancer-free, it is likely that the remaining lymph nodes are also cancer-free, and further lymph node dissection may not be necessary.
Complications
Infection: There is a small risk of infection at the incision site. Patients may be prescribed antibiotics to help prevent infection.
Bleeding: There is a risk of bleeding during the procedure, although this is rare. Patients may be advised to avoid strenuous activity and heavy lifting for several weeks after the procedure to help prevent bleeding.
Numbness or tingling: Some patients may experience temporary numbness or tingling in the arm or chest after the procedure. This is due to the local anesthesia used during the procedure and should resolve on its own.
Allergic reaction: Some patients may have an allergic reaction to the blue dye used during the procedure. This can cause hives, itching, or swelling. Patients should inform their healthcare provider if they have a history of allergies.
False-negative results: In rare cases, the sentinel node may be cancer-free, but cancer cells may still be present in other lymph nodes. Patients may need additional testing or surgery to determine if further treatment is necessary.
False-positive results: In rare cases, the sentinel node may be removed and found to contain cancer cells, but further testing reveals that the cancer has not spread to other lymph nodes or organs. Patients may need additional testing or surgery to determine if further treatment is necessary.
Def.
The sentinel LN BIopsy (SLNB) is a minimally invasive diagnostic procedure used to detect the first lymph node (sentinel node) that drains from a tumor site. In breast cancer indications, SLNB is performed to determine whether cancer cells have spread from the primary tumor to the lymph nodes.
SLNB is a less invasive alternative to traditional axillary lymph node dissection (ALND), which involves the removal of multiple lymph nodes from the armpit. SLNB has been shown to be equally effective in detecting cancer cells in the lymph nodes, with lower rates of complications such as lymphedema and nerve damage.