Sentinel Node Procedures

A sentinel node procedure is performed when specialists suspect cancer may have spread to a patient's lymph nodes.

This involves a:

• Sentinel node scan/study
• Sentinel node biopsy 

A sentinel node biopsy is a procedure used to determine whether cancer has spread to the lymph nodes, particularly in cases of breast cancer and melanoma. The sentinel lymph node is the first node in the lymphatic system that drains fluid from the area around a tumour, and is the node that’s most likely to contain cancer cells if the cancer has started to spread.

Step One: Sentinel Node Study

Firstly you will have an injection of a radioactive marker into the breast to locate the position of the sentinel lymph node. This is the first node in the armpit that filters away fluid from the breast. A special camera then takes pictures and the position of this node is marked. This study happens on the morning of, or the evening before, your surgery.

Step Two: Sentinel Node Biopsy

During the second part of the procedure, your surgeon will use a radioactive detecting device to pinpoint the sentinel node and reveal any other lymph nodes that may be coloured with the blue dye. Your surgeon will make a small incision in the armpit to remove the node(s). The nodes are sent for assessment along with any other tissue removed as part of your breast cancer surgery.

If the sentinel node is free of cancer, it’s unlikely the cancer has spread, and no further lymph node removal may be needed - this reduces the risk of complications like lymphoedema (swelling due to lymph fluid build-up). If cancer is found in the sentinel node, more extensive lymph node surgery may be recommended.

This procedure is a minimally invasive way to stage cancer and guide treatment decisions, with fewer side effects compared to removing a larger number of lymph nodes.

If your sentinel node surgery reveals the presence of cancerous cells, then these results will be discussed in a multi-disciplinary team meeting with the oncologists. The team may recommend follow-up surgery to remove additional lymph nodes, or they may recommend radiotherapy treatment, or other adjuvant treatment. The decision will be based on what is the best treatment for you and your cancer.