Sentinel Node Biopsy

This one is amazing. Not too many years ago, they used to go in and surgically remove all the lymph nodes under the arm by the breast.  This places women at a huge risk for Lympedema, to say nothing of the surgery itself.  Sometimes it was done during the lumpectomy, mastectomy, or just by itself.

Now, they remove the sentinel nodes…the nodes that are the gate-keepers if you will, to the rest. They biopsy for cancer.  IF it is found, then they proceed with further removal and/or chemo and/or radiation.

IF it is not found, they are confident that no further spread has occurred.

The procedure is interesting.  Day 1: Your breast is injected both under the skin and deep in the tissue with an isotope tracer.  They then take images and mark the location of the node as located by a gieger counter (eerie).

Day 2: You are prepped for surgical procedure. You are hooked up to an IV where they administer a sedation for ‘twilight’.  After you are no longer conscious, they inject blue dye and massage the area where it finds the lymph nodes.  The surgeon uses both these and the tracer to locate the sentinel nodes to biopsy.

The blue dye passes out of your system in a day or so… you watch your pee turn bright blue to robin’s egg blue, and your poo a mixed shade of green.  TMI, right?

Similar to the surgical biopsy, they do a nerve block which numbs the breast and arm area for approximately 18 hours.  This is amazing, and done by the anethesiolgist.

So see that big lump in the photo?  Thats the incision area… extremely uncomfortable (like you have a wad of scotch tape under your arm) and surrounding area is very sore.  Some people (depending on the location of your lymph nodes) react like me, others do not.

Because even 1-3 lymph nodes are removed, we are at a greater risk for lympedema, vs. someone who has all their lymph nodes.  Those patients where a total dissection or radiation is prescribed, are at an even greater risk and need to take appropriate precautions.



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