If cancer cells are present (a “positive” biopsy result), then the surgeon may remove the remaining lymph nodes from the area and further testing is necessary to determine whether the cancer has spread beyond the lymph nodes. (He or she may remove more than one lymph node if there are two or more sentinel lymph nodes.) After the sentinel lymph nodes are removed, a pathologist examines them under a microscope to see if they contain cancer cells. The surgeon then removes the sentinel node through a small incision. If blue dye was injected, the sentinel lymph node will be stained blue, which allows the surgeon to locate it. If radioactive dye was injected, the surgeon will use a radiation-detecting device (like a Geiger counter) to locate the sentinel lymph node. The first node into which the injected substances drain is the sentinel lymph node. These substances drain through the lymphatic vessels and into nearby lymph nodes. To do this, a small amount of radioactive material, a blue dye, or both are injected into the tissue near the primary tumor. Before performing this surgical procedure, the surgeon must first identify the sentinel lymph nodes. One way of determining whether certain types of cancer have begun to spread is via SLNB. But some cancer cells may escape and migrate to other lymph nodes or even to distant parts of the body.ĭoctors make decisions on how to best treat cancer patients based on several factors, including whether the cancer has spread to the lymph nodes. The immune system kills many of the cancer cells that reach the lymph nodes. The lymph nodes play a critical role: They filter out waste products, viruses, bacteria, and if they are present, cancer cells. It can also contain cancer cells.īefore lymph reaches the bloodstream, it passes through the lymph nodes. Lymph is made up of various substances including water, cells of the immune system, waste products, and sometimes outside invaders like viruses or bacteria. The system is crucial to maintaining fluid balance in the body. Among other places, clusters of lymph nodes are found in the armpit, neck, abdomen, groin, and chest.Įach of these lymph nodes is part of the lymphatic system, a network of vessels that drains a colorless fluid called lymph away from the body’s tissues and into the bloodstream. This subjected patients to a major surgery with a substantial risk for long-term complications.īut today, doctors can use SLNB to accurately determine if cancer has spread without the need for major surgery and the risks that come with it.Īdults have hundreds of small, bean-shaped structures called lymph nodes spread throughout the body. In the past, before SLNB was in use, to determine whether cancer had spread to the lymph nodes, surgeons typically removed nearly all of the lymph nodes near the site of the cancer. The lymph nodes are then examined to check for the presence of cancer cells. For a patient with breast cancer, for instance, the surgeon will remove lymph nodes in the armpit closest to the affected breasts. In this procedure, a surgeon removes one, or in some cases, a few sentinel lymph nodes-the lymph nodes to which cancer first spreads-near the site of the original tumor. To do this, your doctor might recommend that you undergo a surgical procedure called a sentinel lymph node biopsy (SLNB). It’s important for your doctor to know if the cancer has spread so that he or she can formulate the best course of treatment for you. If you’ve been diagnosed with breast cancer or melanoma, your doctor may have told you that the cancer could spread to nearby lymph nodes and from there, to other, more distant, parts of the body.
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