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Breast surgery - sentinel lymph node biopsy

A sentinel lymph node biopsy is a procedure in which the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present.

What is a Sentinel Lymph Node Biopsy for breast surgery?

The sentinel lymph node is the first lymph node that lymph fluid drains to from the breast, and therefore the lymph node to which cancer cells are most likely to spread from the primary tumour. Sometimes there is more than one sentinel node. The Sentinel Lymph Node Biopsy (SLNB) is a procedure carried out to identify the sentinel lymph node(s) in the breast, so that they can be removed and examined to determine whether cancer cells have spread to them from the main tumour.

How does the SLNB procedure work?

A patient undergoing a Sentinel Lymph Node Biopsy will be injected with a very small dose of radioactive substance and a blue dye near to the nipple; these then enter into the lymphatic channels that subsequently drain into the local lymph nodes. The surgeon will then make a small cut in the armpit and identify the sentinel lymph nodes using a scanning device that detects radioactivity, and remove any lymph nodes that show traces of radioactivity or blue staining from the dye. These lymph nodes are then examined by a pathologist under the microscope for the presence of cancer cells. If cancer cells are found to be present then the surgeon may need to remove further lymph nodes, usually as a follow-up surgical procedure.

What are the benefits of SLNB?

SLNB is beneficial to patient for a number of reasons; in addition to helping doctors 'stage' cancers by identifying which cancers have spread to the lymph nodes, it is also fundamental in avoiding more extensive lymph node surgery. All lymph node surgery can lead to problems with lymph fluid drainage, causing swelling or lymphoedema, and the risk is reduced when fewer lymph nodes are removed.

Are there any risks to SLNB?

As SLNB involve less extensive surgery and removal of fewer lymph nodes than standard lymph node surgery, there is a lower potential for adverse effects or harm. Similar to other surgical procedures, SLNB can cause short-term pain, swelling and bruising at the surgical site; there is a small risk of infection in the wound. Rarely patients can have an allergic reaction to the blue dye used in SLNB. All risks will be discussed in full with patients by the treating consultant prior to the procedure.

For further information or to book a consultation or treatment, please get in touch with our cancer enquiries team: Call us on 0800 157 7747

Content reviewed: October 2014

Specialists Offering Breast surgery - sentinel lymph node biopsy

Mr Dermot Murphy

Consultant Breast Surgeon

MB, BCh, BAO, FRCSI, FRCS (Intercollegiate Gen Surg), BMin

BMI Ross Hall Hospital

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Mr Emad Elseedawy

Consultant General & Breast Surgeon

MB ChB MSc FRCS MD

BMI Kings Park Hospital 1 more BMI Albyn Hospital

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Miss Bareen Shah

Consultant Endocrine and Breast Surgeon

LMSSA (Lond), FRCS, FRCS (Gen surg)

BMI The Clementine Churchill Hospital 2 more BMI Hendon Hospital BMI Syon Clinic

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Mrs Jagdeep Singh

Consultant Oncoplastic and Reconstructive Breast Surgeon

MBBS, MA (Oxon), MD, FRCS, FEBS (Breast Surgery)

BMI Mount Alvernia Hospital

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Mr Sumohan Chatterjee

Consultant Reconstructive Breast Surgeon

MBBS FRCS (CSIG London) FRCS (Gen Surg Intercollegiate)

BMI The Alexandra Hospital

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Mr Sudeendra Doddi

Consultant General, Endocrine and Oncoplastic Breast Surgeon

MBBS, MD, MRCS, MSc, FRCS (General Surgery)

BMI The Blackheath Hospital 3 more BMI Chelsfield Park Hospital BMI Shirley Oaks Hospital BMI The Sloane Hospital

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