Our Summary

This research paper is a review of various studies on a type of biopsy called internal mammary lymph node sentinel biopsy (IMN-SLNB). This procedure is used to check for the spread of breast cancer. The results from different studies were inconsistent, so the authors did a comprehensive review of the existing literature, including 18 articles covering 2,427 patients. They found that about 15% of these biopsies were positive, meaning they detected cancer. However, there was a lot of variation between different studies. Importantly, they found that if a patient had cancer in their axillary lymph nodes (located in the armpit), they were far more likely to also have cancer in their internal mammary lymph nodes. This suggests that the spread of breast cancer to the internal mammary lymph nodes might be underestimated and that doctors should consider doing this biopsy more often, especially in patients with positive axillary lymph nodes. The researchers suggest future studies to determine if having cancer in the internal mammary lymph nodes affects a patient’s chances of survival.

FAQs

  1. What is an internal mammary lymph node sentinel biopsy (IMN-SLNB)?
  2. What was the main finding of this review of studies on IMN-SLNB?
  3. What are the implications of the findings and what do the researchers suggest for future studies?

Doctor’s Tip

A doctor might tell a patient considering a sentinel lymph node biopsy for breast cancer to discuss the possibility of also having an internal mammary lymph node biopsy, especially if cancer is found in the axillary lymph nodes. This additional biopsy can provide more information about the spread of cancer and help determine the best treatment plan. It is important to have an open and thorough discussion with your healthcare provider about the benefits and risks of this procedure.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with early-stage breast cancer, particularly those with invasive breast cancer. Additionally, patients with a larger tumor size, younger age, and those with positive axillary lymph nodes are more likely to be recommended for sentinel lymph node biopsy. The findings of this review suggest that patients with positive axillary lymph nodes may benefit from internal mammary lymph node sentinel biopsy to accurately assess the spread of breast cancer and potentially improve patient outcomes.

Timeline

Before Sentinel Lymph Node Biopsy:

  1. Patient is diagnosed with breast cancer and undergoes various imaging tests to determine the extent of the disease.
  2. Patient discusses treatment options with their healthcare team, including the possibility of a sentinel lymph node biopsy.
  3. Patient undergoes pre-operative preparation, which may include fasting and taking certain medications.

During Sentinel Lymph Node Biopsy:

  1. Patient is brought into the operating room and given anesthesia.
  2. Surgeon injects a dye or radioactive tracer near the tumor to locate the sentinel lymph node.
  3. Surgeon removes the sentinel lymph node(s) for examination.
  4. The tissue is sent to a pathology lab for analysis.

After Sentinel Lymph Node Biopsy:

  1. Patient is monitored for any immediate post-operative complications.
  2. Results from the biopsy are typically available within a few days to a week.
  3. Patient meets with their healthcare team to discuss the findings and determine the next steps in their treatment plan.
  4. If cancer is detected in the sentinel lymph node, further treatment options may be recommended, such as additional surgery, chemotherapy, or radiation therapy.
  5. Patient undergoes regular follow-up appointments and surveillance to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about sentinel lymph node biopsy:

  1. What is a sentinel lymph node biopsy and why is it recommended for me?
  2. What are the potential risks and complications associated with this procedure?
  3. How will the results of the biopsy impact my treatment plan?
  4. Will I need any additional treatments or surgeries based on the results of the biopsy?
  5. Are there any alternative methods to determine if the cancer has spread to my lymph nodes?
  6. How accurate is the sentinel lymph node biopsy in detecting the spread of cancer?
  7. How many sentinel lymph nodes will be removed during the biopsy?
  8. Will I need to stay in the hospital after the procedure?
  9. How long will it take to receive the results of the biopsy?
  10. Are there any long-term effects or implications of having a sentinel lymph node biopsy?

Reference

Authors: Gong J, Yu Y, Wu G, Lin C, Tu X. Journal: World J Surg Oncol. 2019 Aug 5;17(1):135. doi: 10.1186/s12957-019-1683-8. PMID: 31382973