Surgical Procedures: Sentinel Lymph Node Biopsy
Also Referred to as: Sentinel node biopsy, SLN biopsy
What is a Sentinel Lymph Node Biopsy?
Sentinel lymph node (SLN) biopsy is surgery to remove one or a few specific lymph nodes. While under anesthesia, the surgeon injects a blue dye and/or a radioisotope (a nuclear medicine dye) into the area of the tumor. Once the dye(s) are injected, they are picked up by the lymphatic fluid in the area and travel to the local lymph node(s). An incision is made and the surgeon finds the lymph nodes with dye. The nodes that pick up the dye are the sentinel lymph nodes. They are removed and tested for cancer cells.
During this surgery only the sentinel nodes are removed. The remaining nodes are left alone. This reduces the chance of getting a chronic swelling problem called lymphedema.
Will I stay overnight?
No. This is usually done as an outpatient or "same day" surgery. If you are having the SLN biopsy done at the same time as another surgery you may need to stay overnight.
Could I need more surgery?
If cancer is found in one or more sentinel lymph nodes, you and your provider will discuss a treatment plan.
What is recovery like?
You and your surgeon will talk about what your recovery will be like. You will be up and moving the day of or day after surgery. There will be some limitations to your normal schedule and exercise routine in the first week or so. After surgery, you could have side effects including:
- Blue urine and greenish colored stool for 24-48 hours after the injection of blue dye. You are not radioactive after receiving the radioactive tracer.
- Pain, numbness and/or sensitivity in the area of the surgery or the limb where the surgery was done.
- A seroma could develop. A seroma is when lymph fluid collects in the area instead of draining its normal route. It is not worrisome, but can be uncomfortable. Most go away naturally, over time, but may need to be drained in the office with a needle (an easy, painless procedure).
- Lymphedema is a chronic swelling in a body part. There is a low risk of developing lymphedema after this procedure, though this risk is life-long.
Can I prevent infection?
Getting an infection after surgery is not common, but you can help prevent infection by:
- Taking a shower the night before surgery and wash your body with soap and water.
- On the second day after surgery, make sure to shower and clean the incision with soap and water. Pat dry, do not rub the incision. Do this every day, or at least every other day, to keep the incision site clean.
- Do not immerse the incision site in water by soaking in a tub or swimming.
- Always wash your hands before and after touching the incision or changing the dressing.
What will I need at home?
- 4 x 4 gauze pads and 1-inch paper tape to cover the incision if it is leaking.
- Clean, comfy pillow(s) to put under your arm or leg while sitting or to help with positioning at night.
- You may have constipation after surgery due to anesthesia and pain medications. Over-the-counter medications, diet, exercise (as simple as walking), and fluids may ease constipation. Ask your health-care team about over-the-counter medications that may work for you.
Care of the Incision
Your provider will tell you when you should remove your bandage. After it 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.
Often, dissolvable sutures are used 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.
How can I care for myself?
You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.
Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.
There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.
Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.
- Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.
This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.