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Sentinel Node Biopsy

Sentinel node mapping has become a nearly standard treatment in recent years for patients undergoing, or who will undergo, breast-cancer surgery. This type of biopsy helps cancer specialists to determine the extent and status of a breast cancer, while also reducing the amount of surgery necessary.

Virtua’s experienced breast surgeons use a proven technique to help confirm that a breast cancer has not spread or to determine when it has. In sentinel node biopsy – also known as sentinel node mapping – the team injects a radioactive substance or blue dye, or both, in or around the tumor in order to locate the first, or first few, lymph nodes to which the cancer tissue drains – the “sentinel” nodes.

These nodes serve as sentinels or guard nodes because – in the their immune-system function and, here, in their diagnostic function – they are normally the first sites to which to which metastasizing cancer cells spread. The team uses radiologic imaging to determine and mark the location of the tumor, prior to the injection. To track the route of the injected materials, the nuclear medicine department takes images of the pathways that the marker has taken as it leaves the breast.

Rapid Check for Spread at Telltale Locations
The surgeon then uses a device to detect the location of radioactive substance or visually inspects for a blue lymph node, or both. The surgeon removes one or several sentinel nodes through a small incision, and a pathologist examines the nodes microscopically for cancer tissue.

If the sentinel nodes are negative for cancer, then removing additional lymph nodes is unnecessary. If the node is positive for cancer, the surgical team may remove more lymph nodes for examination in the same biopsy session or in subsequent surgery. The primary tumor is usually removed at the same time as the sentinel node, but sometimes patients undergo sentinel biopsy before or after primary surgery.

Proven Value Over More Than 10 Years
This technique has proven valuable over the past decade or so. It can lead the cancer team to detection of even small amounts of cancer cells and, thus, can help to alter the overall staging of the cancer and treatment approach. Experienced surgical teams, such as those at Virtua, can determine if breast caner has spread in nearly all patients who undergo this type of biopsy.

The approach also limits the amount of surgery required to determine the extent of the disease and promotes a faster recovery. It continues to eliminate the need to perform more involved surgeries (protective surgeries to remove all nearby lymph nodes, called axillary node dissections) for many patients. And it helps patients avoid the significant swelling and soreness associated with these conventional types of lymphatic surgery.

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