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About the Procedure

Pea-sized lymph nodes are part of the body’s lymph vessel system – small channels that drain excess fluid from all the tissues of the body back into the bloodstream. As the fluid drains it goes through the nodes, which act as filters that trap bacteria, cancer cells and other harmful substances for the immune system to attack before they enter the bloodstream and travel to other parts of the body.
“The sentinel lymph nodes are the first nodes to receive lymph drainage from the breast and the first lymph nodes to receive cancer cells from a breast tumor as the cancer tries to metastasize, or spread, from the primary tumor,” said Dr. Aanestad. “There commonly is a limited set of one to three sentinel lymph nodes in each underarm. If the sentinel nodes do not show any cancer, there is a greater than 95 percent chance that the remaining axillary lymph nodes in the underarm area also are cancer free.”

The procedure can lead to a faster and more accurate assessment of whether the cancer has spread to the lymph nodes. Instead of removing most of the lymph nodes under the arm to randomly search for any evidence of cancer spread, Sentinel Lymph Node Biopsy allows the surgeon to identify the one or two SLNs to which the cancer would spread first. In this way, the pathologists can perform an intensive analysis of the sentinel nodes instead of sorting through 10-25 lymph nodes.

Another advantage of the procedure is that if the SLNs are found to be free of cancer, there is no need to perform a traditional complete Axillary Lymph Node Dissection. This procedure, in which all or almost all of the lymph nodes under the arm are removed, can cause patient side effects such as lymphedema (swelling caused by excess fluid build-up), numbness, a persistent burning sensation, infection, and stiffness.

“Sentinel Lymph Node Biopsy is a more conservative approach, with fewer side effects and faster recovery times, but still is highly effective in helping us determine whether or not the cancer is invasive,” said Dr. Aanestad. “That’s why it has become the procedure of choice for women with breast cancer.”  

The procedure begins when the patient is injected with a small amount of radioactive tracer and a blue dye around the breast cancer. These substances are absorbed by the lymph system and help the doctor identify the sentinel lymph node(s) – which will be blue and emit a small amount of radiation. A special device called a gamma probe is used to pick up the radioactive signal.

The surgeon then makes a small incision and removes the sentinel node (or nodes). A pathologist then examines the sentinel lymph node (or nodes) under a microscope. If cancer cells are not seen, it is unlikely that the cancer has spread to the other lymph nodes and there is no need to remove them.
All the lymph nodes in the area are removed, however, if cancer is present in the SLN. The lymph nodes may also be taken out if the sentinel lymph node cannot be located.

The Sentinel Lymph Node Biopsy can be done in combination with a lumpectomy, a mastectomy or as a separate procedure. When done as a separate procedure the entire biopsy, including the time it takes for the radioactive tracer to be absorbed prior to surgery, takes about three hours. Sentinel Lymph Node Biopsy may be performed on an outpatient basis. But, when done with cancer-removal surgery, a hospital stay may be required.

The Center for Breast Health, located in Medical Office Building 1 on Genesis Medical Center’s East campus, 1228 E. Rusholme St., Davenport, serves nearly 7,000 women annually. It’s the first facility in the region to offer comprehensive breast care in one location through the latest diagnostic technology and treatments, including digital mammography, which allows earlier detection of breast cancer for younger women and women whose traditional mammograms have been difficult to interpret. The Center for Breast Health team approach uses the combined resources of primary care physicians, radiologists, pathologists, surgeons, oncologists, psychologists, nurses, technologists and others to provide specialized care for women with abnormal mammogram findings., slp3d’s Web portal, will host the webcast. OR-Live is the Web’s largest source of live and on-demand surgical video from leading hospitals and academic institutions. Its Web site attracts an average of nearly 500,000 unique visitors each month. Audiences come from all 50 states as well as from nearly 200 countries in North America, Central and South American, Europe, Asia, Africa and Oceania.

Previous Genesis webcasts have spotlighted minimally invasive Transforaminal Lumbar Interbody Fusion to eliminate back pain, laparoscopic Roux-en-Y gastric bypass, a surgical procedure for weight loss and minimally invasive thoracic aortic aneurysm repair.

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