What is breast cancer?

Breast cancer is a harmful growth that starts in the glandular tissue of your breast.

What is a lymph node?

Lymph nodes are small structures which lie along lymph vessels present throughout your body.

A sentinel node biopsy involves removing the sentinel nodes from your armpit. Sentinel nodes are the first lymph nodes in your armpit to which breast cancer cells may spread.

What are the benefits?

The lymph nodes that your surgeon removes will be examined under a microscope to see whether they contain cancer. The result will help to decide on further treatment, without needing to remove all of the lymph nodes from your armpit.

Are there any alternatives?

If the lymph nodes in your armpit are found to contain cancer, the breast-care team may offer a procedure called axillary node clearance to remove all the lymph nodes under your arm.

Your breast-care team may offer surgery to remove a sample of the lymph nodes from your armpit (axillary node sampling).

What does the procedure involve?

You may be asked to come to hospital before your procedure for an injection into your breast. The injection contains a fluid (tracer) which travels to the sentinel nodes and becomes trapped there.

The procedure is performed under a general anaesthetic and usually takes 20 to 30 minutes.

During the procedure your surgeon may inject a blue dye into your breast. The dye travels to the sentinel node and stains it blue.

Your surgeon will make a cut in your armpit, below the area where hair grows.

Your surgeon will remove the nodes identified using the blue dye or tracer.

The lymph nodes that your surgeon removes will be examined under a microscope. Your surgeon will know the results 2 to 4 weeks later.

If cancer cells are found in the sentinel nodes it means the cancer may have spread to other lymph nodes in your armpit. Your breast-care team may recommend further treatment to your armpit, depending on how many of the sentinel nodes contain cancer.

What complications can happen?

Possible complications of this procedure are listed below. Some may be serious and can even be life threatening.

General complications of any procedure

• infection of the surgical wound
• allergic reaction to the equipment, materials or medication
• venous thromboembolism (VTE)

Specific complications of this procedure

• bleeding
• developing a lump under your wound caused by fluid collecting
• developing a lump under your wound caused by blood collecting
• numbness or continued pain around your armpit or the inner part of your arm
• swelling of your arm, hand or breast
• allergic reaction to the tracer
• discolouration of your urine, stools and tears for 1 to 2 days
• sentinel node not found
• failure to find cancer cells
• infection of the affected arm

Consequences of this procedure

• pain
• scarring of your skin

What happens after the procedure?

You should be able to go home the same day or the day after.

You should be able to build up to normal activities after 2 to 3 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask your breast-care team or your GP for advice.

Your breast-care team will arrange an appointment for you after surgery. The lymph nodes and any breast tissue that your surgeon removed will have been examined under a microscope. Your surgeon will tell you the results and discuss with you any treatment or follow-up care you need. They will also check your wound and be able to tell you when you can return to work.

Summary

Sentinel nodes are the first lymph nodes in your armpit to which breast cancer cells can spread. A biopsy to remove the sentinel nodes gives your breast-care team important information to help plan your future breast cancer treatment.

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