Removing sentinel nodes can cause life-long complications such as lymphedema, with symptoms including swelling, arm stiffness, numbness, and pain. Recent research shows that this may be the case for up to 80% of patients. However, this means that patients who do not have invasive cancer found in the breast will have sentinel nodes removed unnecessarily. This is done as a precaution in case invasive cancer is discovered in the breast, because marking of the sentinel nodes is not possible after mastectomy due to the pathways for the tracer being removed with the breast. The common practice is to perform a sentinel lymph node biopsy at the time of a mastectomy for DCIS. While sentinel lymph node biopsy has reduced the amount of initial surgery for patients compared to the former standard of early cancer care – axillary lymph node dissection, where all lymph nodes are removed from the underarm – it may still represent overtreatment in cases of non-invasive breast cancer (DCIS). This information is important for breast cancer staging and future treatment decisions. This process helps the surgeon identify the most likely lymph nodes to be affected if an invasive breast cancer has spread. The lymphatic vessels in the breast pick up the tracer/s and take them to the first draining lymph nodes in the axilla (the sentinel nodes). If an invasive breast cancer spreads to the lymph nodes, it will first go to these sentinel nodes.ĭuring a sentinel lymph node biopsy, the breast is injected with a magnetic tracer, blue dye, radioactive tracer or combination of the three. The first lymph nodes to receive fluid from the breast are called the sentinel lymph nodes. The breast drains through lymphatic vessels that lead to lymph nodes in the axilla (under the arm). It provides an opportunity for up to 80% of high-risk DCIS patients to protect lymph nodes that do not need to be removed.Ī sentinel lymph node biopsy is the most common cancer staging process for patients with high-risk DCIS. A delayed sentinel lymph node biopsy is a procedure that allows the surgeon to perform surgery to stage the axilla only when it is truly necessary.
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