​Summary:

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A sentinel lymph node biopsy (SLNB) is a minimally invasive procedure that helps determine whether breast cancer has spread to the lymph nodes. It plays a vital role in staging the disease and planning further treatment. 

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What is a Sentinel Node?

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The sentinel lymph node is the first lymph node (or group of nodes) that drains lymphatic fluid from the breast. It acts as the “first checkpoint” for cancer cells that may travel beyond the breast.

 

By examining the sentinel node, doctors can accurately determine whether breast cancer has spread to the lymphatic system. If the sentinel node is free of cancer, it is highly likely that the remaining lymph nodes are also clear — meaning further axillary surgery can often be avoided.

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Before the Procedure

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• Either the day before or on the morning of surgery, a small amount of radiotracer (a safe radioactive substance) is injected into the breast. This travels naturally through the lymphatic channels to the sentinel node, allowing it to be identified during the operation.

• You will meet your surgeon and anaesthetist before surgery to review the plan and ask any questions.

• Occasionally, a small amount of blue dye may be used, but we rarely use dye to avoid staining or allergic reactions.

• The radiotracer allows the surgeon to locate the sentinel node precisely using a special detector during surgery.

• The procedure is typically performed at the same time as your lumpectomy or mastectomy.

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During the Procedure

 

 

• Anaesthesia:

  The procedure is performed under general anaesthetic, so you are asleep and comfortable throughout.

• Localisation:

  The surgeon uses a radioguided probe to locate the sentinel lymph node based on the radiotracer signal.

• Node Removal:

  One to three lymph nodes are carefully removed for analysis. The exact number varies, depending on how many absorb the radiotracer. The aim is always to remove only the sentinel nodes while preserving the rest of the healthy lymphatic tissue.

• Specimen Handling:

  The removed nodes are sent to the laboratory for microscopic analysis to determine whether any cancer cells are present.

  It is not possible to identify cancer by sight during surgery — detailed laboratory examination is essential.

• Closure:

  The incision is closed with dissolvable sutures and sealed with glue or steri-strips.

• Duration:

  The procedure usually takes 30–45 minutes, and is often performed during your main breast surgery.

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After the Procedure

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• You’ll wake up in the recovery area and usually go home the same day.

• Mild bruising, swelling, or tenderness in the armpit or breast is common and settles within a few days.

• The dressing is waterproof, and you can shower from the day after surgery.

• You can resume gentle daily activities when comfortable but avoid heavy lifting for about one week.

• If you had a lumpectomy, continue wearing your own surgical bra day and night for at least two weeks.

• Driving is permitted after your first postoperative review, once arm movement is comfortable and you’re no longer taking strong pain medication.

• Pathology results are usually available within 7–10 days and will be discussed at your follow-up appointment.

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Possible Risks and Side Effects

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While sentinel lymph node biopsy is very safe, possible risks include:

 

• Mild bruising or discomfort in the armpit or breast

• Small fluid collection (seroma)

• Temporary numbness or tingling in the upper arm

• Infection (rare)

• Shoulder stiffness (uncommon and short-lived)

• Lymphoedema (arm swelling) — extremely rare (<2%) because only a few nodes are removed

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Our Innovative Approach at Breast & Wellness

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At the Breast & Wellness Centre, we perform sentinel lymph node biopsy using an innovative through-the-breast approach.

Instead of making a separate axillary incision, the lymph nodes are accessed through the same incision used for breast surgery (lumpectomy or mastectomy).

 

This advanced technique offers:

 

• No separate axillary scar — improved cosmetic outcome

• Less pain and stiffness in the armpit

• Reduced risk of axillary web syndrome

• Shorter recovery time and quicker return to normal activity

 

 

We also avoid routine use of blue dye, instead using modern radioguided localisation for safe and precise sentinel node detection. This approach provides excellent accuracy and comfort while maintaining the highest standards of cancer care.

 

Key Points

 

• Identifies whether breast cancer has spread to lymph nodes

• Sentinel node = first lymph node to receive lymphatic drainage from the breast

• Performed during lumpectomy or mastectomy

• Through-the-breast approach avoids a separate armpit scar

• Blue dye not used routinely

• You can shower from the day after surgery

• Driving permitted after your first postoperative review

• Extremely low risk of lymphoedema (<2%)

• Typically a day procedure with quick recovery