What is a sentinel lymph node biopsy (SLNB)? 

A sentinel lymph node biopsy (SLNB) is a procedure used to determine whether breast cancer has spread to the lymph nodes. The sentinel lymph node is the first lymph node or group of nodes that cancer cells are likely to spread to from the primary tumour. By identifying and examining these key lymph nodes, doctors can assess the spread of cancer and plan further treatment.  

Why is a sentinel lymph node biopsy important? 

The lymphatic system plays a crucial role in the body’s immune response and is also a common route for the spread of cancer cells. In breast cancer, the spread of cancer cells to the lymph nodes under the arm (axillary lymph nodes) can affect the stage of cancer and the treatment approach. 

By examining the sentinel lymph node, doctors can determine if cancer has spread beyond the breast. If cancer cells are found in the sentinel lymph node, it may indicate that cancer has spread to other lymph nodes or parts of the body. This information is critical for staging breast cancer and deciding on the most appropriate treatment, such as chemotherapy, radiotherapy, or additional surgery. 

The sentinel lymph node biopsy procedure 

Sentinel lymph node biopsy is a minimally invasive procedure and typically involves the following steps: 

• Injection of dye or radioactive tracer: Before surgery, a small amount of blue dye, radioactive tracer, or both is injected into the area around the tumour. This helps to identify the sentinel lymph node, which is the first node to absorb the dye or tracer from the breast. 

• Locating the sentinel node: Once the dye or tracer has moved through the lymphatic system, the surgeon uses a special probe or follows the blue-stained lymph vessels to locate the sentinel node. 

• Removal of the sentinel lymph node: The identified lymph node(s) is then surgically removed through a small incision. In most cases, only one to three lymph nodes are removed. 

• Examination of the lymph node: The removed sentinel node is sent to the laboratory for analysis. Pathologists will check for the presence of cancer cells in the lymph node. 

The entire procedure is usually performed under general anaesthetic and takes approximately 1-2 hours. Most patients can return home on the same day, with minimal recovery time. 

Who is sentinel lymph node biopsy suitable for? 

SLNB is primarily recommended for patients who: 

• Have early-stage breast cancer (cancer that has not spread to other parts of the body). 

• Have a clinically negative axilla, meaning that no enlarged or suspicious lymph nodes are detected during a physical examination or imaging tests. 

• Are undergoing a mastectomy or breast-conserving surgery (lumpectomy). 

SLNB may also be used in certain cases of ductal carcinoma in situ (DCIS) when there is a risk that invasive cancer may be found during surgery. 

Benefits of sentinel lymph node biopsy 

The sentinel lymph node biopsy has several advantages, including: 

• Minimally invasive: SLNB removes fewer lymph nodes than traditional axillary lymph node dissection (ALND), reducing the risk of complications such as lymphedema (swelling of the arm). 

• Accurate staging: It provides crucial information about whether the cancer has spread to the lymph nodes, helping guide treatment decisions. 

• Reduced side effects: By targeting only the sentinel lymph nodes, patients typically experience fewer side effects, such as numbness, pain, and swelling. 

Risks and complications 

As with any surgical procedure, sentinel lymph node biopsy carries some risks. These may include: 

• Lymphedema: Although the risk is lower than with full lymph node removal, some patients may develop swelling in the arm due to fluid build-up after the procedure. 

• Infection: There is a small risk of infection at the site of the incision. 

• Allergic reaction: Rarely, patients may have an allergic reaction to the blue dye used in the procedure. 

• Temporary skin discolouration: The blue dye used in SLNB may cause temporary discolouration of the skin, which usually fades over time. 

After the procedure 

Following the sentinel lymph node biopsy, your surgeon will discuss the results with you. If cancer cells are found in the sentinel lymph node, further treatment may be recommended, such as: 

• Axillary lymph node dissection (ALND): Removal of additional lymph nodes if cancer has spread. 

• Radiotherapy or chemotherapy: To target any remaining cancer cells in the body. 

Why choose Birmingham Breast Clinic? 

At Birmingham Breast Clinic, we offer expert, compassionate care for women undergoing sentinel lymph node biopsy. We provide: 

• Personalised treatment plans: Tailored to your specific diagnosis and health needs. 

• Expert surgeons: Our team is skilled in performing sentinel lymph node biopsies and providing comprehensive breast cancer care. 

• Comprehensive support: From diagnosis to treatment and recovery, we are with you every step of the way. 

Contact us 

If you have been diagnosed with breast cancer and need a sentinel lymph node biopsy, contact Birmingham Breast Clinic to schedule a consultation. Our team is here to provide expert guidance and support throughout your treatment journey.