The Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 14, 2013
Also Referred to as: Sentinel node biopsy, SLN biopsy
A surgical procedure to determine if cancer cells are in the lymph nodes under the arm. Only the lymph node(s) that drain fluid from the breast (called sentinel nodes) are removed. The remaining nodes are left alone. This significantly reduces the chance of developing a chronic swelling problem called lymphedema.
In the operating room, under anesthesia, the surgeon injects a blue dye and/or a radioisotope (a nuclear medicine dye) into the breast. Once the dye(s) are injected, they are picked up by the lymphatic fluid in the breast and travel the normal route to the lymph node(s) under the arm. An incision is made under the arm and the surgeon finds the lymph nodes with dye and removes them. It is important to understand that lymph node(s) having dye in them does not mean that they have cancer in them, only that they are the right lymph nodes to check for cancer.
No. This is usually done as an outpatient or "same day" surgery.
If cancer is found in one or more sentinel lymph nodes, you will have a discussion with your surgeon to determine if you should have more lymph nodes removed.
Your surgeon will discuss specific recovery issues with you. In general, you will be up and moving the day after surgery, with some limitations to your normal schedule and exercise routine in the first week or so. After surgery, you could experience any of the following side effects:
If you have a post-surgical bandage, remove per your surgeon's instructions (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Avoid lotions, powders or deodorant on or near the incision during the first 1-2 weeks until it is fully closed.
Most surgeons use dissolvable sutures so you won't see any sutures and they don't need to be removed. On the outside, some surgeons use surgical glue over the incision to give added protection, others use paper tape called "steri-strips" while some use nothing at all. Both glue and steri-strips can get wet in the shower.
Walking is good. Take rest periods throughout the day as needed. Move your arm on the side of surgery as naturally as possible; do not feel as if you have to guard the area.
Deep breathing and relaxation are important to help with pain, keep lungs healthy after anesthesia and promote good drainage of lymphatic fluid. Try to perform deep breathing and relaxation exercises several times a day in the first week, or whenever you notice you are particularly tense.
This hand-out provides general information only. Please be sure to discuss the specifics of your surgical plan and recovery with your surgeon.