When you find out that you or someone you know has cancer, one of the biggest fears that comes to mind is, "Has it spread to other parts of the body?" That's actually a reasonable fear. Today, we're going to talk about a very important test that doctors use to find the answer to that question. It's called a Sentinel Node Biopsy.
What is Sentinel Node Biopsy in simple terms?
To understand this, let's first learn a little about the lymph nodes in our bodies. These are small bean-shaped glands located all over our bodies. They are like "filters" in our bodies. Their job is to filter the fluids in our bodies and catch harmful things like germs, bacteria, and cancer cells. It's like a police checkpoint.
Now imagine that if cancer cells start to spread from a tumor, there are several lymph nodes that those cells are likely to first stop in . Those first 'gateway' lymph nodes are what we call "sentinel nodes."
Simply put, a sentinel node biopsy is the surgical removal of one or more sentinel nodes, which are like the first checkpoint, to determine if the cancer has spread, and then testing them for cancer cells.
In what cases is this test performed?
Doctors mainly use this test to determine the stage of cancer. That is, to find out how far the cancer has spread and how serious it is. This is especially important in these situations:
- Breast Cancer
- Melanoma skin cancer
In addition, this method is also used to determine the stage of penile cancer and endometrial cancer. Currently, research is underway to determine how effective this method is for several other types of cancer. These include cervical cancer, colorectal cancer, and thyroid cancer.
Most often, this biopsy is done at the same time as the surgery to remove the main tumor, but sometimes it can be done separately, before or after.
How should I prepare before this surgery?
Since this is a surgical procedure, it is very important to follow your doctor's instructions exactly. You will usually receive instructions on things like:
- Fasting: When to stop eating and drinking before surgery and what to stop eating.
- Medicine:If you are taking any medications, vitamins, or other supplements, your doctor will ask if you need to stop taking any of them.
Also, it is important to talk to someone to take you home after the surgery.
How is the surgery done?
This process happens very systematically.
Before or during surgery, your doctor will inject a special substance into your tumor. This may be a safe radioactive substance (tracer) or a blue dye. This substance travels from the tumor to the sentinel node, which is the "first checkpoint." This helps the surgeon find the exact node to remove.
Then let's see what happens step by step.
| Steps | What is happening? |
|---|---|
| 1. Anesthesia | You will be completely anesthetized (completely unconscious) so that you will not feel any pain. |
| 2. Finding the Sentinel Node | If the radioactive material has been injected, the location of the node is found with a special device called a gamma detector. If the blue dye has been injected, the node will appear blue. Sometimes both methods are used. |
| 3. Removing the node | The surgeon makes a small incision and removes one or more of the identified sentinel nodes (usually 1 to 5). |
| 4. Sending for testing | The removed nodes are sent to a lab, where a pathologist examines them under a microscope to see if they contain cancer cells. The incision is then closed with stitches. |
What can you expect after surgery?
Most people can go home the same day, but you may need to stay in the hospital overnight. Remember that it is normal to experience these things during the recovery period after surgery.
- It hurts where the incision was made, and it hurts when you press on it .
- The skin in that area feels numb (this is what happens when those nerves are restored).
- Your urine or stool may turn blue or green for a few days because of the blue shirt you used.
- The skin around the incision looks blue .
- A lump-like feeling of hardness under the skin as the wound heals.
- If you have removed a tick from your armpit, you may feel some tightness or discomfort in your arm .
Before you leave the hospital, ask your doctor or nurse about how to care for your wound and what precautions you need to take. Also ask when you can start exercising and lifting weights again.
What are the risks and complications of this surgery?
This is a largely safe surgery, but as with any surgery, there are some minor risks.
| Risk/Complication | Description |
|---|---|
| Wound-related problems | The incision site may bleed, bruise, swell, and be painful. Sometimes the wound can become infected. If the wound is red, swollen, and has a fever, that is a sign of infection. |
| Allergic Reaction | Very rarely, some people may be allergic to that blue color. |
| Lymphedema | When lymph nodes are removed, the flow of lymph fluid can be obstructed, causing the fluid to pool and cause swelling in the arm or leg. However, this risk is much lower when only a few sentinel nodes are removed. |
| Axillary Web Syndrome (AWS) | This is also a rare occurrence. When lymph nodes are removed from the armpit, you may feel a string-like sensation under the skin on the inside of your arm. |
If you experience any of these symptoms, notify your doctor immediately.
How does the test report come in? What does it mean?
The results of the report are of two types: either 'Negative' or 'Positive' .
- If the result is 'Negative':
That means no cancer cells were found in your sentinel nodes. This is very good news because it means that the cancer is very unlikely to have spread to other lymph nodes.
- If the result is 'Positive':
This means that there are cancer cells in the sentinel nodes that were removed. At this point, your doctor may decide to further investigate how far the cancer has spread and remove more lymph nodes. Or, he or she may recommend other treatments, such as radiation therapy.
The time it takes to get results can vary. It may be the same day, or it may take several weeks.
When should I call the doctor?
If you notice any of these symptoms after surgery, call your doctor without delay.
- If you have a fever .
- If the incision site is swollen, red, or feels warm .
- If the wound continues to bleed .
- If you have unbearable pain even after taking painkillers.
Take-Home Message
- Sentinel node biopsy is a very important test to determine if cancer has spread to other parts of the body.
- The results from this will be of great help to doctors in determining the stage of your cancer and planning future treatment.
- This is generally a safe surgery, and any side effects that may occur can often be managed.
- A 'negative' result is a good sign that the cancer has not spread, while a 'positive' result provides guidance for future treatment.
- Talk openly with your doctor about any questions or concerns you may have before or after surgery.
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