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Sentinel Node Biopsy

What is sentinel node biopsy?

The sentinel lymph node (SLN) is the first axillary lymph node that will collect cancerous cells from the breast if the cells have entered the lymphatic system. It was named "Sentinel" for its protective function as a "guard" lymph node. There can be one or more sentinel lymph nodes found on a sentinel lymph node biopsy.

A sentinel lymph node biopsy is a surgical procedure that identifies and removes the sentinel lymph node(s). The pathologist will examine and determine if the breast cancer cells are present (positive) or not present (negative).

Sentinel Node Biopsy

A sentinel node biopsy determines if breast cancer has spread to the lymph nodes. An important part of staging cancer, it impacts recommendations for a patient's treatment. At Johns Hopkins, the sentinel node biopsy is the standard of care for determining the presence of cancer in the axillary lymph nodes.

How do sentinel node biopsy results affect treatment?

The sentinel lymph node(s) will be sent to pathology for analysis and staging of the breast cancer.  The pathology report will then be shared with you at your one week post operative appointment.   If the sentinel lymph node is negative for tumor cells, the remaining lymph nodes are left intact  This reduces the risk of lymphedema in the future, as well as preserves healthy tissue that doesn’t need to be surgically disturbed. However, if the node is positive, a more comprehensive decision will be made whether other nearby nodes need to be removed and examined for cancer in a future surgery.

At the Johns Hopkins Breast Center, our surgeons have been performing sentinel node biopsies since 1996, when they began as clinical trials. Because of our work—and that of colleagues at other centers—sentinel node biopsy is now the standard of care for determining the presence of cancer in the axillary lymph nodes.

Knowing if the cancer has spread to the nearby lymph nodes is a critical part of staging, and therefore impacts the recommendations for treatment of the patient’s breast cancer.