What is a Sentinel Lymph Node Injection and Node Biopsy?

Written by Claire Johnson / Image by storyset on Freepik

What is a Sentinel Lymph Node Injection?

This is a procedure before your surgery that identifies the first and most likely main lymph node that drains from your tumour and therefore identifies if there is a likelihood, or not, of the cancer cells from the tumour/s having spread. If the sentinel node is clear, then there is a strong likelihood that the rest of the lymph nodes are clear as well.

What will happen on the day I have this procedure?

A very small amount of carefully measured radioactive blue dye is injected directly into or beside your nipple, which may sting for only a few seconds. This is administered by a specialist nurse, who is trained in nuclear medicine.

This can be done the day before your surgery or on the day of the surgery, as the dye stays in your system for a couple of days. It is completely harmless, and the radioactivity leaves your body via your urine, which may well be discoloured for a few days. However, the blue dye staining may last on your breast at the site of the injection for several months, this varies from person to person.

What can I expect to happen?

You will be requested to remove all of your clothing above the waist and will be supplied with a hospital modesty gown. When you walk into the room the machine itself is very large and the room is also kept quite cold. You will be asked by the Specialist Nurse to remove your gown and lay on a bed that has a slider on it.

Once you are laying down comfortably, the nurse will administer the injection and you will be asked to massage it to encourage the dye to spread deeper into your breast for a few minutes.

After this, you will be moved to the middle part of the machine and the two panels that are to the side of you will spin around (you will stay still). If you are lucky, after this, the Specialist Nurse may show you the Radioactive dye “tracking” through your breast on a screen, which appears as twinkling stars. This is not at all painful and quite interesting.

The next section of the same machine is a little bit like a CT scanner (not as claustrophobic as an MRI machine). You will be moved into this section of the machine on the slider where your head will be in the open but your breast will be directly under the machine to enable visual 3D images to be taken for the surgeon to use, to help Identify your Sentinel Lymph Node. This section lasts for about 10 minutes and is not at all painful but it can be a little bit noisy. Once this is completed, you will be asked to sit up gently, get dressed, and then leave the room.

What happens next?

As part of your planned surgery, your Surgeon will use a very sensitive Radiation Detector Wand to locate your sentinel node that has the radioactive dye in it. The Surgeon will then remove this node (and possibly a few nodes surrounding the sentinel node) and send it off to the hospital laboratory for close analysis. You will be told after your surgery how many lymph nodes have been removed in addition to the sentinel node.

Please note, we are not medical professionals, if you have concerns please contact your doctor/health care provider.