What Is The Sentinel Lymph Node?
Oncological pathologies often lead to excessive use of different procedures when patients are treated. The technique that addresses the sentinel lymph node saves a few steps and avoids unnecessary surgery.
The sentinel lymph node is the first place cancer cells reach when they separate from the primary tumor. It is not a metastasis in the broadest sense of the word, but the mechanism is similar. From cancer located in one organ, malignant cells migrate to other areas. Some reach a nearby lymph node.
In the case of breast cancer, sentinel lymph node analysis is essential to determine the stage of the disease, ie the actual size of the tumor in the body. Through a sentinel node biopsy, doctors can predict the evolution of the condition in the person concerned.
In addition, the data provided by the sentinel lymph node helps to plan post-biopsy therapy. Given the spread of cancer, doctors can decide whether to use surgery, chemotherapy plus radiation or any other combination of treatments.
Evolution due to the sentinel lymph node
This is not a minor intervention and one of the most common side effects is lymphedema, which consists of obstruction of lymphatic circulation. In this case, due to lack of circulation, the fluid drains into the soft tissues, inflaming the upper limbs.
The removal of the entire lymphatic chain had two objectives: diagnosing the stage of cancer and treating any metastases located in the body. The problem with this technique was that if the result of the subsequent biopsy was negative, then the whole operation would have been in vain and the woman would have had to suffer unnecessary side effects.
The idea of reducing the scale of the operation is to improve the quality of life of patients. Intervention will still be needed, but the incision is smaller, and the surgeon will remove the lymph node only if the biopsy reports the presence of malignant cells.
Sentinel lymph node: biopsy
The sentinel lymph node biopsy procedure is part of the protocol for certain types of breast cancer. Experiments have also been performed on melanomas, but there are still discussions about the usefulness of the intervention.
As previously mentioned, this biopsy takes a sample from the first ganglion that the primary tumor cells would reach, in order to locate the malignant cells. If the result is negative, then we can be sure that the tumor is located only in the organ.
The biopsy involves a smaller incision than needed for major lymphatic chain removal surgery, but can have side effects. The most common are subsequent bleeding caused by the wound and infection at the puncture site. However, the risk is very low.
How do doctors know which sentinel node is?
To perform the biopsy, doctors must first identify the sentinel node. To do this, they use techniques that make this ganglion stand out. In this way, the surgeon can find the correct location for the procedure.
One way to mark the sentinel node is through radioactivity. First, a solution with radioactive power is injected into the areas near the primary tumor. This solution will migrate to the lymphatic system and radioactivate the first ganglion in the chain.
Another technique is to use blue dye. Instead of a radioactive substance, a blue dye is injected, which follows the same path, passing from the area of the primary tumor to the first node nearby.
The choice of the best method depends on the team treating the condition. Both are effective in locating the sentinel node, and their side effects are minimal. The radioactive substance is weak and does not cause problems in the cells. Blue paint can cause a bluish stain of urine for a while.
