Until late last century, when a woman had breast cancer she underwent surgery to remove all axillary lymph nodes on the same side, because it was considered that they could facilitate the spread of tumor. But in the 90s it was discovered what is known as sentinel node, which is a nodal level that separates breast lymph from the rest of axillary lymph. If the sentinel node is free of tumor cells, the remaining axillary nodes are also allowed.
It was during those years when he began performing in Spain selective sentinel node biopsy, which involves locating the nodal level, intervene by General surgery on the nodes that form and analyze whether or not they contain tumor cells, before considering removing the other axillary nodes.
How sentinel nodes located?
There are several methods for locating SNs. Among them, there are two techniques that can be used separately or together, and having a high rate of patient safety.
This is on the one hand, the injection of a dye is injected into the breast just preoperatively. This dye stains the sentinel nodes and enables the surgeon to distinguish from the rest and extirpate. Furthermore one can also inject a substance with traces of radioactivity, which identifies the SNs also for the surgeon to intervene on them.
The latter method requires a nuclear medical intervention, and lymphoscintigraphy is performed after injecting the radioactive substance preoperatively.
Who sentinel node technique performed?
Selective sentinel node biopsy is performed in women with breast cancer and be subjected to an intervention, but where there is no evidence that tumor cells have reached the axillary lymph. Using ultrasound it is studied whether there are suspicious lymph nodes and, if so, are analyzed in a biopsy. If the results are negative, the patient may be a good candidate for intervention sentinel node.
Complications of sentinel node removal
All interventions involve some risk, and the same applies in this case. But because of the simple surgery and its minimally invasive nature, potential complications from the operation are minimal.
Still, there is a possibility that the patient has an infection of the surgical wound or some bruising. It can also occur lymphatic fluid to accumulate, lymphedema light, scarring retractions, allergy to any component of the method and underarm discomfort or tightness, among others.
All these possible complications are much rarer than the effects that occur remove all axillary nodes.