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Sentinel Lymph Node Biopsy in Breast Cancer

Targeted axillary staging procedure

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Sentinel Lymph Node Biopsy in Breast Cancer?

SLNB uses radioactive technetium-99m sulfur colloid, blue dye, or both injected near the tumor or peritumorally to map lymphatic drainage to the first axillary nodes.

Sentinel nodes are identified intraoperatively with a gamma probe and visual inspection, then excised for histopathologic examination.

Indications include early-stage breast cancer (T1-T2, clinically node-negative), DCIS undergoing mastectomy, and selected post-neoadjuvant cases.

When metastasis is detected, axillary lymph node dissection or radiotherapy is considered based on tumor burden and ACOSOG Z0011 criteria.

Symptoms

Diagnosed early-stage breast cancer requiring axillary staging
Clinically negative axilla on examination and ultrasound
Positive imaging finding of breast mass without palpable nodes
Recent biopsy confirming invasive breast carcinoma
Indication during mastectomy for high-grade DCIS
Restaging after neoadjuvant chemotherapy in selected patients

Risk Factors

Underlying breast cancer with risk of axillary metastasis
Allergy to blue dye (rare anaphylaxis risk with isosulfan blue)
Pregnancy (radiotracer used cautiously, blue dye contraindicated)
Prior axillary or breast surgery may alter lymphatic drainage
Inflammatory breast cancer (SLNB not recommended)
Multifocal or large tumors require careful patient selection

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Newly diagnosed early breast cancer requiring surgical planning
  • Discussion of axillary staging options before surgery
  • Concern about lymphedema risk with axillary dissection
  • Postoperative pathology results requiring multidisciplinary review
  • Suspected complications (seroma, infection, lymphedema) post-SLNB
  • Recurrence assessment after prior breast cancer surgery

Treatment Methods

01
Preoperative lymphoscintigraphy to map sentinel nodes when needed
02
Combined radioisotope and blue dye technique for highest detection rate (above 95 percent)
03
Intraoperative frozen section or one-step nucleic acid amplification (OSNA) when results impact further axillary surgery
04
Pathologic ultrastaging with serial sectioning and immunohistochemistry
05
Adjuvant therapy decisions based on sentinel node status (ACOSOG Z0011 criteria)
06
Postoperative arm exercise and lymphedema surveillance program

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.