Sentinel Lymph Node DissectionDelivering Quicker Recovery with Less Pain
Whether you are having a lumpectomy with radiation therapy or mastectomy, most patients will undergo a sentinel lymph node dissection. Until 15 years ago, almost all breast cancer patient underwent a complete axillary lymph node dissection. This meant removing almost all the lymph nodes in the underarm area. One of the significant complications of axillary lymph node dissection is lymphedema, or significant swelling of the arm. This is thought to occur in almost 15% of patients undergoing complete axillary lymph node dissection.
However, over the past 15 years, a less invasive procedure is now the standard, sentinel lymph node dissection. The idea is to find the initial draining lymph node, and if this does not have cancer then neither should the remainder of the lymph nodes. This enables only one or 2 lymph nodes to be removed in the overwhelming majority of patients instead of all the lymph nodes. This has decreased the risk of lymphedema to 3%. To find this lymph node, the patient will be injected with a marker in radiology on the day of surgery. The patient will also have injection of blue dye in the operating room. This will enable us to find the sentinel lymph node in 90-95% of cases.