Sentinel node in breast cancer

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Sentinel lymph nodes provide valuable information to guide breast cancer treatment. Lymph nodes are kidney bean—shaped structures found throughout the body that are an important part of the immune system. Foreign particles such as bacteria or tumor cells can travel in lymphatic channels toward lymph nodes, which act as a filter.

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The sentinel lymph node SLN is the first axillary lymph node that will collect cancerous cells from the breast if the cells have entered the lymphatic system. It was named "Sentinel" for its protective function as a "guard" lymph node. There can be one or more sentinel lymph nodes found on a sentinel lymph node biopsy.

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The sentinel lymph node advantageously replaces axillary dissection as a staging method in breast cancer T1 and T2 2. Sentinel lymph nodes are affected in the following stages: T1a 4. In recent years the management of breast cancer has changed considerably.

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Sentinel lymph node biopsy has become a standard staging tool in the surgical management of breast cancer. The positive impact of sentinel lymph node biopsy on postoperative negative outcomes in breast cancer patients, without compromising the oncological outcomes, is its major advantage. It has evolved over the last few decades and has proven its utility beyond early breast cancer.

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Sentinel node biopsy identifies the first few lymph nodes into which a tumor drains. The surgeon uses a harmless dye and a weak radioactive solution to locate the sentinel nodes. The nodes are removed and tested for signs of cancer.

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According to sentinel lymph node SLN hypothesis, tumor cells migrate in an orderly manner from a primary tumour, metastasizing to one or a few LNs before involving others. Therefore, SLN is defined as the first LN that receive lymphatic drainage from the primary tumour, if the tumour has spread. The advent of percutaneous lymphoscintigraphy allowed Robinson et al.

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During surgery for invasive breast cancer and sometimes for ductal carcinoma in situ DCISone or more lymph nodes in the underarm area axillary lymph nodes are removed to check for cancer cells. The surgeon will likely make a separate incision cut in the underarm area below where your underarm hair grows to remove these nodes. The presence or absence of cancer in these nodes is an important factor affecting cancer stage and prognosis.

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Sentinel node biopsy is a surgical procedure doctors use to see whether early-stage breast cancer has spread beyond the tumor and into the lymphatic system. The sentinel nodes are the first lymph nodes a cancer is expected to move into. If there is evidence of malignancy there, there is a known possibility of it spreading to other parts of the body as the cancer cells circulate in lymphatic fluid. It's often performed alongside surgery for breast cancer but may also be done on its own.

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A usual part of breast cancer surgery is to remove the lymph nodes from the armpit axilla to see if there is any evidence that the cancer has spread from the breast to the lymph nodes and therefore, potentially, to other parts of the body. This information, along with other factors such as the size and grade of the tumour, helps the doctors determine the stage of the breast cancer and the most appropriate treatment. One potential side effect of removing the lymph nodes from the armpit is a life-long risk of developing lymphoedema swelling in that arm.

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Skip to Content. To help doctors give their patients the best possible care, the American Society of Clinical Oncology ASCO provides recommendations on sentinel lymph node biopsy for people with early-stage breast cancer. This guide for patients is based on the most recent recommendations. Breast cancer begins when normal cells in the breast change and grow out of control, forming a mass called a tumor.

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