Our Summary

This research paper explores the effectiveness of a specific type of biopsy, known as sentinel lymph node biopsy, in patients with breast cancer who have undergone chemotherapy. The biopsy is performed to check if the cancer has spread to the lymph nodes. The study analyzed 13 past studies involving a total of 1,921 patients.

The results showed that the biopsy was successful in identifying the presence of cancer 90% of the time. However, it failed to detect cancer that was actually present 14% of the time. The study also found that using two different methods to perform the biopsy (dual mapping) was more accurate than using just one method (single mapping).

In addition, the results showed that removing more lymph nodes during the biopsy made it more accurate. When only one node was removed, the biopsy failed to detect cancer 20% of the time. This rate dropped to 12% when two nodes were removed and to just 4% when three or more nodes were removed.

The study concluded that sentinel lymph node biopsy is generally reliable and accurate for patients who have had chemotherapy for breast cancer, but the procedure needs to be carried out with precision and appropriate patient selection.

FAQs

  1. What is the success rate of detecting cancer through sentinel lymph node biopsy?
  2. Does the number of lymph nodes removed during the biopsy impact its accuracy?
  3. What is the significance of dual mapping in sentinel lymph node biopsy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to discuss with them the importance of removing multiple lymph nodes during the procedure to increase accuracy in detecting cancer spread. The study suggests that removing three or more nodes can significantly reduce the risk of false negative results. Additionally, considering dual mapping techniques for the biopsy may also improve the accuracy of the results. It is important for patients to have open communication with their healthcare provider about these factors to ensure the best possible outcome from the biopsy.

Suitable For

Patients who are typically recommended sentinel lymph node biopsy include those with early-stage breast cancer who have undergone chemotherapy, as well as those with larger tumors or tumors that are close to the lymph nodes. Additionally, patients who have a high risk of lymph node involvement, such as those with aggressive tumor types or younger age, may also be recommended for this procedure. It is important for healthcare providers to carefully assess each patient’s individual risk factors and treatment history to determine the most appropriate course of action.

Timeline

Before the sentinel lymph node biopsy, a patient typically undergoes imaging tests to determine the location of the sentinel lymph node. They may also receive a radioactive tracer injection or a dye injection to help identify the sentinel lymph node during the procedure. The day of the biopsy, the patient will go to the hospital or outpatient facility, where they will be given anesthesia before the procedure.

After the biopsy, the patient may experience some pain, swelling, or bruising at the site of the incision. They may also have limited range of motion in their arm on the side where the biopsy was performed. The patient will need to follow post-operative care instructions, such as keeping the incision clean and dry, avoiding heavy lifting, and taking prescribed pain medication as needed. The patient will also have a follow-up appointment with their doctor to discuss the results of the biopsy and any further treatment recommendations.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and why is it recommended for me?
  2. How will the biopsy be performed and what should I expect during and after the procedure?
  3. What are the potential risks and complications associated with the biopsy?
  4. How accurate is the biopsy in detecting the spread of cancer to the lymph nodes?
  5. Is there a difference in accuracy between using one method (single mapping) versus using two methods (dual mapping) for the biopsy?
  6. Is there a difference in accuracy based on the number of lymph nodes removed during the biopsy?
  7. How will the results of the biopsy impact my treatment plan?
  8. Are there any alternative methods to determine if the cancer has spread to the lymph nodes?
  9. Are there any specific guidelines or criteria for selecting patients who are suitable candidates for a sentinel lymph node biopsy?
  10. What is the follow-up plan after the biopsy and how will the results be communicated to me?

Reference

Authors: Tee SR, Devane LA, Evoy D, Rothwell J, Geraghty J, Prichard RS, McDermott EW. Journal: Br J Surg. 2018 Nov;105(12):1541-1552. doi: 10.1002/bjs.10986. PMID: 30311642