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The sentinel lymph node is the first lymph node (or few lymph nodes) to which breast cancer cells may travel. A sentinel lymph node biopsy is a surgical procedure by which your surgeon will remove the sentinel lymph node and send it to the pathology lab for examination.

If cancer cells have traveled to the sentinel lymph node, your surgeon may remove more lymph nodes from your axilla (under your armpit).

The sentinel lymph node biopsy allows some women without lymph node involvement by cancer cells to avoid more extensive surgery in the underarm area, known as the axilla.

What should you know about this biopsy?

Your surgeon will explain the biopsy procedure and will have you sign a consent form.

• A "tracer" will be injected into the breast near the area of your tumor. A tracer is a blue dye, a radioactive tracer or both.

  This injection will be done by a radiologist in the Nuclear Medicine Department. The radiologist will discuss the injection with you and will ask you if you have any allergies or have had any reactions to dyes or tracers.

• Following the injection of the tracer, your surgeon, in the operating room, will see the path of the "tracer” leading to the area in your axilla. The surgeon will then make a small incision and remove the lymph node (or a few lymph nodes) that have taken up the "tracer.”

• These lymph nodes will be sent to the pathologist who will freeze them and perform a quick look to see if any cancer cells are visible. This practice varies by surgeon.

  If cancer cells are present in the lymph nodes, your surgeon may remove more lymph nodes at that time while you are still in surgery. If the examination of the frozen lymph node does not show cancer cells, no further lymph nodes will be removed at that time. It is possible that later a more thorough examination by a pathologist may show cancer cells. These cancer cells may not be seen at the time of the "quick look” of the frozen lymph node. If the pathologist finds cancer cells, you will need another surgical procedure to remove more lymph nodes.

• 4. Some people have noticed that they develop a slight bluish tint to their skin after having a sentinel node biopsy. If this occurs, it will fade over the next 24 hours.

How will I find out the results of the biopsy?

Depending on your surgeon, you may find out the results of the frozen lymph node quick look immediately after surgery. The final results of the examination of your sentinel lymph node will usually be available in five working days. Your surgeon will discuss these results with you.

When should I call the doctor?

Call your doctor if you notice any of the following:

• Fever of 100.5°F or above.
• Pain at the incision site that is not controlled by the medicines for pain that your doctor has prescribed.
• Uncontrolled bleeding, redness or swelling at the incision site.