LUMPECTOMY WITH SENTINEL
LYMPH NODE

Overview

A lumpectomy is a surgical procedure for removal of a cancerous lump from the breast. A sentinel lymph node biopsy is a procedure that may be done at the same time, which involves your surgeon locating and removing the first lymph node or nodes under the armpit that receives the lymph drainage from the breast. These lymph nodes are called the sentinel lymph nodes. By removing the sentinel lymph nodes, your oncology team can tests whether or not the cancer has spread and possibly prevent the spreading of cancer to other parts of the body through the lymphatic system.

Indications

A lumpectomy and sentinel lymph node biopsy is done as part of cancer treatment. It involves removing the tumour from the breast. In addition it is beneficial to do a sentinel lymph node biopsy. As an alternative an axillary node dissection may be done with the lumpectomy to remove all of the lymph nodes under the armpit.

What happens during a lumpectomy and sentinel lymph node biopsy?

Once under general anesthesia, an incision is made near the lump and the lump is removed as well as a small margin of the surrounding tissue. The rest of the breast is left intact.

Next a radioactive dye is injected into the bloodstream. Using a hand-held detector, this dye will help Dr Heyns identify the first lymph nodes to which cancer cells are likely to spread from the breast tumor. Through a small incision in the armpit, the nodes containing the dye will be removed. The sentinel nodes will be examined in the lab for cancerous cells and you will be told a few days later whether cancer was found in these nodes.

If cancer is found in the lymph nodes, then you will usually be advised to schedule more surgery to remove the remaining lymph nodes in the armpit before you have chemotherapy or radiation therapy.

What to expect after surgery

When waking from anaesthesia, you can expect some pain and tenderness in the particular breast and in your armpit. Pain relievers will be prescribed to make you comfortable. You will only need to stay in hospital for a day or two before you can be discharged. Dr Heyns will talk to you about caring for your incisions after surgery and any restrictions of activity, but recovery usually takes a week or two.