GUARD LYMPH NODE BIOPSY IN THE BREAST CANCER SURGERY (SENTINEL LYMPH NODE BIOPSY-SLNB) 

Among the breast cancer surgical applications, it is perhaps one of the most important surgical developments in terms of giving importance to the patient’s quality of life. As a result of many years of studies, it has been shown that removal (dissection) of the axillary lymph nodes in the breast cancer is not very effective in the survival of the disease, it provides information about the course of the disease and local control is achieved by removing the cancerous gland in the axilla. It is a scientific fact that approximately 70% of patients in the early stage of the breast cancer do not have cancer cells in their axillary fossa. Here, the guard lymph node biopsy method prevents conditions such as swelling in the arm (lymphedema) that negatively affect the quality of life of this group of patients. With the guard lymph node biopsy performed in the breast cancer surgery in the last 20-25 years, we can have information about the condition of the disease in the axillary fossa without removing excess lymph nodes, usually with the procedures performed during the operation. 

HOW TO APPLY: 

In this surgical method, while the patient is under the anesthesia, at the beginning of the operation, we examine the axillary fossa by giving the breast a blue dye and/or a minimal dose of radioactive material. We find the lymph node with a high level of stained and/or radioactivity measurement and we call this lymph node a sentinel lymph node. We send this gland for pathological examination while the patient is asleep during the surgery. As a result of the rapid pathological examination, which takes about half an hour, if there is no cancer cell in this gland, we do not remove the other glands. In this way, our patients are much less likely to encounter negativities such as swelling in the arm (lymphedema) and limitation of shoulder movements, which impair the patient’s quality of life. If there are cancer cells in the guard gland, sometimes other axillary lymph nodes can be surgically removed depending on the type of surgery performed on the breast, the characteristics of the tumor and the number and characteristics of the guard lymph node. This process for the axillary fossa can be performed if the patient does not have a lymph node that can be cancerous under the axillary fossa as a result of the pre-operative examination, imaging and pathological examinations. It is recommended that the guard lymph node biopsy is performed by experienced breast surgeons in suitable patients. 

Wishing you healthy days… 

Surgeon Ali ÖZLÜK