Our Summary

This study looked at two different surgical techniques used for a type of breast cancer surgery called sentinel lymph node biopsy (SLNB). This surgery is done to see if the cancer has spread to the lymph nodes. The researchers wanted to see which technique was better in terms of how the surgery went (things like how much blood was lost or how long the surgery took) and what kind of complications patients had after the surgery.

They looked at 330 breast cancer patients who had this surgery in their hospital from 2018 to 2021. They found that one of the techniques, called the axillary cribriform fascia approach, generally had better results during the surgery and was less likely to cause problems with the patients’ arms after the surgery.

They also found that patients with a higher body mass index (BMI) had more drainage, longer tube time, and a longer surgery time. However, the number of sentinel lymph nodes did not make a difference in how the surgery went or what kind of complications happened after.

They also found that radiotherapy, another type of cancer treatment, increased the risk of swelling in the arm (upper limb edema). In conclusion, the axillary cribriform fascia approach for SLNB seems to be a better choice for breast cancer patients.

FAQs

  1. What is a sentinel lymph node biopsy (SLNB) and why is it performed?
  2. What is the axillary cribriform fascia approach in sentinel lymph node biopsy?
  3. How does a patient’s body mass index (BMI) and use of radiotherapy affect the outcomes of sentinel lymph node biopsy?

Doctor’s Tip

A doctor might tell a patient undergoing a sentinel lymph node biopsy to discuss the axillary cribriform fascia approach with their surgeon to potentially have better outcomes during and after the surgery. They may also advise patients with a higher BMI to be aware of potential complications such as increased drainage, longer tube time, and longer surgery time. Additionally, patients who undergo radiotherapy should be aware of the increased risk of developing swelling in the arm. It is important for patients to have open and honest discussions with their healthcare team to ensure the best possible outcome for their individual situation.

Suitable For

Patients with early-stage breast cancer who are recommended to undergo a sentinel lymph node biopsy include those with:

  • Tumors smaller than 5 centimeters
  • Tumors that are invasive but have not spread beyond the breast
  • Tumors that are non-invasive but have a high risk of becoming invasive
  • Patients with no clinical signs of lymph node involvement
  • Patients with clinically negative axillary lymph nodes

It is important for patients to discuss with their healthcare provider to determine if they are a good candidate for sentinel lymph node biopsy based on their individual medical history and tumor characteristics.

Timeline

Before Sentinel Lymph Node Biopsy:

  1. Patient is diagnosed with breast cancer and discusses treatment options with their healthcare team.
  2. Patient and healthcare team decide that a sentinel lymph node biopsy is needed to determine if the cancer has spread to the lymph nodes.
  3. Patient undergoes pre-operative evaluations and tests to prepare for the surgery.

During Sentinel Lymph Node Biopsy:

  1. Patient undergoes the sentinel lymph node biopsy surgery, which involves injecting a radioactive tracer or dye near the tumor to identify the sentinel lymph node.
  2. Surgeon removes the sentinel lymph node for examination to determine if cancer cells are present.
  3. Surgery typically takes about 1-2 hours and is done under general anesthesia.

After Sentinel Lymph Node Biopsy:

  1. Patient is monitored in the recovery room before being discharged home.
  2. Patient may experience some pain, swelling, or bruising at the surgical site.
  3. Patient may have a drain tube in place to help remove excess fluid from the surgical area.
  4. Patient is instructed on how to care for the surgical site and manage any discomfort.
  5. Patient follows up with their healthcare team for pathology results and further treatment planning based on the findings of the biopsy.

What to Ask Your Doctor

  1. What is sentinel lymph node biopsy (SLNB) and why is it necessary for my breast cancer treatment?
  2. What are the potential risks and complications associated with SLNB?
  3. How will the choice of surgical technique for SLNB affect my recovery and potential complications?
  4. Are there any specific factors, such as my BMI or history of radiotherapy, that may impact the outcome of SLNB for me?
  5. How many sentinel lymph nodes are typically removed during the procedure and does this impact the outcome?
  6. What are the potential long-term effects of SLNB, such as lymphedema or arm swelling?
  7. How should I prepare for the SLNB procedure and what can I expect during the recovery process?
  8. Are there any additional tests or treatments that may be recommended based on the results of SLNB?
  9. How often will I need to follow up with my doctor after SLNB and what signs should I watch for that may indicate a complication?
  10. Are there any alternative options to SLNB that I should consider?

Reference

Authors: Chang JY, Wang W, Shen JL, Zhang Y, Cai HF. Journal: Updates Surg. 2023 Apr;75(3):757-767. doi: 10.1007/s13304-022-01417-z. Epub 2022 Nov 16. PMID: 36385610