The Sentinel Node in Surgical Oncology
This examination may be done at the time of the surgical procedure or later. If there is no tumor in these lymph nodes, no additional lymph nodes need to be removed. However, if tumor cells are detected in these first draining lymph nodes, removal of additional lymph nodes a complete axillary lymph node dissection may be required.
Sentinel lymph node biopsy helps determine how invasive the cancer is, and therefore is also used to determine what treatment options are likely to be the most effective. A sentinel lymph node biopsy also may allow for the avoidance of a complete lymph node dissection.
In the past, if any lymph node had cancer, a complete lymph node dissection was performed. Any surgery on the lymph nodes can lead to complications including lymphedema , but minimizing surgery on lymph nodes decreases the risk of developing these complications.
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The blue dye can occasionally be seen on the breast skin and last for a few months. It does get absorbed into the system and may shed a "blue cast" to the skin for the first few hours.
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Also, it is excreted through the urine and the following day, your urine may turn blue. Both the blue dye and the radioactive material travel to the lymph nodes. These specific nodes, "blue" to the naked eye of the surgeon and or "hot" from the radioactive material when using a hand-held Geiger counter, will be sampled. If these nodes show cancer cells, then a routine axillary dissection will be performed. A drain will be placed for several days and the patient usually stays overnight in the hospital.
If the nodes are negative, then usually no other nodes are removed and a patient may go home after surgery. Occasionally, neither of these techniques points to any lymph nodes in the axilla and a routine axillary dissection will be performed.
This may be seen if the breast tumor surgery was already performed and was extensive. A delayed routine axillary dissection will then to be performed.
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