This information provides you with an understanding of the procedures you will experience with the removal of your sentinel lymph nodes (SLN). The SLN is defined as the first lymph node the breast cancer would spread to and is believed to be the msot likely to contain cancer in the event of spread. The nodes are found during your surgery by means of a special technique that typically uses radioactive and blue-colored dyes which help the surgeon identify them. Usually, one to four SLN’s are found. Sentinel lymph node biopsy has been developed to decrease the potential complications of removing multiple lymph nodes in your armpit.
Who is a candidate for this procedure?
If your invasive tumor is 3 cm or less, and your surgeon does not feel cancer in your lymph glands, then you can have this procedure.
Intra-operative “Radioactive” Mapping:
Your surgeon injects a small amount of radioactive material (called technetium sulfur colloid) into the skin or tissue around the site of the breast cancer. The amount of radiation exposure with this procedure will be less than that of a routine chest xray. The material moves through the breast’s lymphatic channels, and a special hand-held probe determines the location of the ‘Hot’ lymph nodes in your armpit. Your surgeon will then make a small incision over this area, and find the sentinel node.
Intra-operative “Blue Dye” Mapping:
Your surgeon injects the second blue dye (isosulfan blue) into the tissue around the breast cancer. The dye is picked up by the lymphatic vessels and then travels to the sentinel nodes. The SLN turns blue and can be identified more easily. The blue dye may discolor the injected skin, the lymphatic channels, and the urine. The blue color in the skin can remain for several weeks (sometimes months). The urine will return to normal color in 2-3 days. There is a possibility of allergic reaction to the blue dye at the time of injection, although this is rare.
All sentinel lymph nodes removed will be sent to the pathology department where they will be more closely examined. All of the information about your lymph nodes will be reported in your pathology report within one week after your surgery.
