Sentinel Lymph Node Biopsy – Understanding the Procedure

What is a Sentinel Lymph Node Biopsy?

A sentinel lymph node biopsy is a minimally invasive procedure used to determine if cancer has spread beyond the primary tumor site. This technique focuses on removing only the first lymph node or group of nodes where cancer cells are likely to spread, known as the sentinel lymph nodes.

This approach helps reduce the need for more extensive surgery, improving recovery while providing essential staging information for cancers such as melanoma and breast cancer.

Benefits of Sentinel Lymph Node Biopsy for Patients

Choosing a sentinel lymph node biopsy offers significant advantages:

• Minimally invasive: The procedure targets only key lymph nodes, avoiding complete lymph node dissection when possible.
• Lower risk of complications: Reduces the chances of lymphedema, nerve injuries, and wound issues.
• Accurate staging: Provides critical information to guide personalized treatment plans.
• Improved outcomes: Studies show that patients may experience enhanced survival rates with appropriate use of SLNB.

What to Expect Undergoing the Sentinel Node Biopsy

The sentinel lymph node biopsy is typically performed on an outpatient basis and involves minimal surgical intervention.

Locating the Sentinel Lymph Nodes

Prior to the operation, you will undergo a test called a lymphoscintigram to identify the sentinel lymph node basin. A small amount of fluid is injected into the skin around the melanoma, and blue dye is injected in the operating room. This test allows for the removal of only the first draining lymph nodes, whereas in the past, all lymph nodes in the draining basin would be removed.

Recovery and Side Effects

Most patients experience mild discomfort, requiring only over-the-counter pain medication. The incision is small, with a low risk of complications such as:

• Lymphedema
• Infection
• Bleeding
• Seroma formation (fluid buildup)

Overall, sentinel lymph node biopsy is considered a safe, reliable procedure for staging cancers like melanoma and breast cancer.

Patient Experience with Sentinel Lymph Node Biopsy

Patients undergoing SLNB can expect a relatively quick and minimally invasive procedure. Some discomfort may be experienced during the injection of the radiotracer, but numbing agents can help minimize this. Most patients can leave the hospital on the same day and resume normal activities shortly after.

Advancements in Sentinel Lymph Node Biopsy

Ongoing research continues to refine sentinel lymph node biopsy techniques:

• New guidelines from the American Society of Clinical Oncology (ASCO) focus on improving accuracy while reducing unnecessary invasive procedures.
• In certain low-risk cases, SLNB can now be safely omitted, lowering complication risks and enhancing quality of life.
• Saint John’s Cancer Institute is at the forefront of these advancements, offering patient-centered care and access to innovative clinical trials.

Saint John’s Cancer Institute – Pioneering Sentinel Lymph Node Biopsy

In the early 1990s, Dr. Donald Morton developed a groundbreaking method to identify the sentinel lymph nodes, revolutionizing surgical oncology worldwide. Before this innovation, patients with intermediate-risk melanoma often underwent complete lymph node removal, leading to higher rates of complications like lymphedema and nerve damage.

Dr. Morton, serving as chief of the melanoma program and co-director of the surgical oncology fellowship at the John Wayne Cancer Institute (now Saint John’s Cancer Institute), introduced the use of dye and radiotracers to precisely locate the sentinel lymph nodes. This advancement allowed for targeted removal and microscopic examination to assess cancer spread, particularly benefiting melanoma and breast cancer patients.
Today, the Saint John’s Cancer Institute remains a global leader in sentinel lymph node biopsy, cancer research, and patient care.

The Borstein Family Foundation Melanoma Program, a center of excellence at the Saint John’s Cancer Institute, is one of the most experienced melanoma research centers in the world. Together, with expert physicians of Saint John’s Health Center, we offer patient-specific treatment options including access to advanced clinal trails. Contact us today to schedule an appointment.