Sentinel Lymph Node Biopsy for Breast Cancer: Understanding SLNB to Determine Whether Cancer Has Spread

Sentinel Lymph Node Biopsy (SLNB) is a surgical procedure performed to remove one or more sentinel lymph nodes and examine them in a laboratory to determine whether cancer cells are present. In patients with breast cancer, this examination can help doctors determine whether cancer cells have spread from the primary tumor to the lymph nodes.

Lymph nodes are part of the lymphatic system, which filters body fluids and helps fight infections. These nodes are located throughout the body, including in the armpit area. In breast cancer, the lymph nodes in the armpit are one of the areas that may need to be examined because cancer cells can spread through the lymphatic system.

Sentinel lymph nodes are the first lymph nodes that cancer cells are likely to reach when spreading from a breast tumor. Therefore, doctors remove and examine these nodes through SLNB to determine whether cancer cells are present and help guide the next steps in treatment.

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When is sentinel lymph node biopsy performed?

Doctors primarily use sentinel lymph node biopsy, or SLNB, as part of cancer staging for breast cancer and melanoma. Cancer staging helps doctors determine whether cancer has spread and how advanced it is. SLNB can also help determine the stage of penile cancer and uterine cancer (endometrial cancer).

Researchers and healthcare professionals are still studying the use of SLNB for staging several other types of cancer, including:

Cervical cancer.
Colorectal cancer.
Esophageal cancer.
Non-small cell lung cancer.
Thyroid cancer.
Vulvar cancer.

Doctors usually perform this procedure at the same time as tumor removal. However, in certain circumstances, SLNB may be performed before or after the primary tumor is removed.

How is SLNB performed?

Before the procedure, the doctor first identifies the sentinel lymph nodes using a radioactive solution, blue dye, or both.

Radioactive solution: A low-dose radioactive solution is injected near the cancerous area. The solution then follows the lymphatic flow toward the sentinel lymph nodes. The injection is usually given several hours or a day before the procedure.
Blue dye: A safe blue dye is injected near the cancerous area and travels toward the sentinel lymph nodes, causing them to turn blue and making them easier to identify. The dye is usually injected shortly before the procedure.

During the procedure:

Anesthesia: The patient is usually given anesthesia to remain asleep during the procedure.
Making a small incision: The doctor makes a small incision in the area where the lymph nodes are located.
Identifying the sentinel lymph nodes: If a radioactive solution is used, the doctor uses a special device called a gamma detector to locate lymph nodes with the highest level of radioactivity. If blue dye is used, the sentinel lymph nodes can be identified by their blue color.
Removing the sentinel lymph nodes: The doctor then removes the sentinel lymph nodes, which usually consist of several nodes.
Laboratory examination: The removed lymph nodes are sent to a laboratory and examined under a microscope to determine whether there are signs of cancer cells.
Timing: SLNB can be performed at the same time as cancer removal surgery or before or after the surgery.

SLNB results and when to expect them

SLNB results can be either positive or negative, with the following meanings:

Negative result: No cancer cells are found in the sentinel lymph nodes. This indicates that the likelihood of cancer having spread to other lymph nodes is lower.
Positive result: Cancer cells are found in one or more sentinel lymph nodes. The doctor may recommend further examination or removal of additional lymph nodes, as well as additional treatment depending on the patient’s condition.

SLNB results may be available on the same day or take several weeks, depending on the laboratory examination process and the patient’s condition. If a positive result is identified on the same day, the doctor may be able to remove additional lymph nodes for examination immediately, so the patient may not need to undergo another surgery.

In some cases, results may take longer if the doctor needs to discuss them with the cancer care team before determining the next steps in treatment.

SLNB at Mandaya Royal Hospital Puri

SLNB can be performed at Mandaya Royal Hospital Puri as part of an evaluation to determine whether breast cancer cells have spread to the lymph nodes. The procedure is tailored to each patient’s condition and needs following an examination and consultation with the doctor.

With the support of a medical team and cancer care facilities, patients can receive the examinations and treatment they need based on their condition through an integrated service. The doctor will explain the purpose of SLNB, the procedure involved, and the examination results to help determine the next steps in treatment.

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*The information provided on this page is intended for educational purposes and general information only and does not represent the full range of medical services that may be provided by each doctor. To determine the appropriate treatment based on your health condition, consultation with the relevant doctor is recommended.

If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.