Hi everyone. Today I want to talk about something I hope none of you have to encounter--the sentinal lymph node biopsy. This is a procedure done by surgeons in order to identify if high risk tumors have started to spread, or metastasize, in order to determine the prognosis . I hope to shed some light on this topic so you can be educated should you have to discuss this option with your dermatologist and surgical oncologist. "High risk tumor" is a broad term used to describe deep melanomas or any other skin cancer which has a rate of metastasis. In general, a melanoma whose depth is greater than one millimeter, or less commonly a very large and deep squamous cell carcinoma would be considered high risk tumors. About 30 or 40 years ago, patients with a large melanoma underwent a "lymph node dissection" in order to determine if the cancer had spread to the lymph nodes. The idea behind this is the assumption that if a cancer spreads, it would ...
One main lymph node area (the armpit, or "axilla") and two secondary lymph node areas (the internal mammary and supraclavicular regions) filter the lymph fluid draining away from the breast area.
Since the job of the lymph nodes is to filter out "bad guys" like cancer cells, this is a logical place to look for breast cancer cells that have escaped the original tumor and are trying to go elsewhere in the body. Cancer cells may also leave the breast through the bloodstream and bypass the lymph nodes. However, the presence ("node-positive") or absence ("node-negative") of cancer in the lymph nodes is one of the most important signposts your doctor will use to determine the best treatment for you.
“The bottom line is that if your lymph nodes are involved, it tells your doctors a lot about the nature of your cancer. It means that this is a tumor with a potential nasty streak and a higher risk of spreading to other parts of your body. Knowing the bottom line can help guid...
Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy
Carlson RW, Allred DC, Anderson BO, Burstein HJ, Carter WB, Edge SB, et al. Breast cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw . 2009;7:122-192.
Clinical practice guideline for melanoma: NCCN Medical Practice Guidelines and Oncology; V.2.2010. Available online.
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