The spread of cancer cells is crucial to determine the treatment that will be administered. The wider the spread, the higher the cancer stage, and the treatment will certainly differ from the early stage. One way to assess the spread of cancer cells is through sentinel lymph node biopsy.
What is Sentinel Lymph Node Biopsy (SLNB)?
The sentinel lymph node is the first location where cancer cells spread. Breast cancer cells generally spread first to the lymph nodes in the armpit.
There are quite a few of these nodes, ranging from 20 to 140. In the past, when doctors wanted to determine the spread of breast cancer, all of these lymph nodes would be removed.
This procedure is called lymph node dissection. Over time, this dissection procedure has been replaced by biopsy or tissue sampling alone.
Sentinel lymph node biopsy is the process of biopsying lymph nodes to see how far cancer has spread in the body, thus determining the stage of breast cancer and allowing doctors to plan treatment accurately. This procedure can be performed in several ways:
- Blind biopsy: Tissue samples are taken without the use of contrast, resulting in a larger sample size.
- Using ICG dye: ICG or indocyanine green dye is used to provide contrast between normal and abnormal tissue.
- Using methylene blue dye: This dye is used to contrast tissue, but it is not as accurate as ICG.
- Using radioactive solution: Radioactive solution is injected into the area near the cancer.
Currently, the majority of hospitals in Indonesia still use the first method, blind biopsy. However, Mandaya Royal Hospital Puri already uses the second method by injecting ICG into the lymph nodes. Thus, when SLNB is performed, fewer tissues are removed, and the results obtained are more accurate.
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Procedure for Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy is performed by a surgical oncologist. After undergoing this procedure, patients usually do not need to stay in the hospital; they only require a few hours of monitoring before being allowed to go home.
Here are the steps patients will go through during SLNB:
- Patients will be anesthetized to avoid feeling pain during the procedure.
- After the anesthesia takes effect, the doctor will inject ICG dye so that the tissue inside has a contrasting color between healthy and abnormal.
- The doctor will then perform a biopsy with a special tool equipped with a camera so that the colored tissue in the lymph nodes can be clearly seen.
- The doctor will remove the necessary tissues.
- These tissues will then be sent to the laboratory to determine whether they are malignant.
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What Should Be Prepared Before Undergoing SLNB?
Not much needs to be prepared before undergoing sentinel node biopsy. Doctors may suggest some restrictions or preparations according to the patient’s health condition, such as stopping blood-thinning medications for some time before the biopsy.
SLNB Risks
In general, this procedure is safe to perform. However, like any other medical procedure, there are some risks that may occur, such as pain or bruising at the biopsy site.
Breast Cancer Treatment at Mandaya Royal Hospital Puri
Sentinel Lymph Node Biopsy with ICG Mapping is one of the procedures available at BRAVE, the breast cancer center at Mandaya Royal Hospital Puri. This leading center is supported by 31 multidisciplinary specialist doctors, ranging from consultant surgical oncologists to professors in radiology. This experienced team of doctors can provide the most suitable treatments for patients comprehensively, ranging from radiotherapy, immunotherapy, chemotherapy, nuclear medicine, to supportive services such as pain clinics, state-of-the-art laboratories, and home and palliative care.
Breast cancer can be cured as long as treatment is administered as early as possible and detected at an early stage. Therefore, women are advised to undergo regular check-ups, including mammograms and general health check-ups if they experience symptoms that may be suspicious of breast cancer. Visit the breast lump center at Mandaya Hospital to receive a comprehensive examination from early screening to treatment. Use the Chat feature via WhatsApp or Book Appointment via our website to make your visit more comfortable. You can also download our Care Dokter App to make bookings, check queue, and obtain other health information.
