Sentinel Node Biopsy for Lymph Node Removal

Surgeons have begun to offer biopsy of the sentinel lymph node (the first node breast cancer strikes) as an alternative to removing several lymph nodes in women with small spreading breast cancers.

This procedure would eliminate the need for general anesthesia, which is used for surgical removal of the nodes, and would spare women the pain and discomfort common with the more extensive lymph node dissection. Surgical removal of the axillary lymph nodes can result in numbness, scarring, and lymphedema, or swelling.

The value of sentinel lymph node biopsy was described by two national experts at the 29th National Conference on Breast Cancer.

Outlining the benefits of the procedure were Drs. Laura Liberman, associate attending radiologist, Memorial Sloan-Kettering Cancer Center, New York, NY and Stefanie S. Jeffrey, chief of breast surgery, Stanford University School of Medicine, Stanford, CA.

The sentinel node is the first node draining a tumor and whether the node contains cancer cells predicts the status of the regional nodes. The sentinel node can be identified with blue dye, radioisotope, or a combination of methods, excised, and analyzed.

Women with small breast cancers detected by screening mammography are least likely to have cancer in the nearby lymph nodes and, therefore, are likely to benefit from removal of these nodes. They would benefit most from the sentinel node breast biopsy.

Sentinel lymph node biopsy is most appropriate for women with small, spreading cancers. In these patients the frequency of finding cancer in the axillary nodes is 24-34 per cent.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.