Sentinel Node Biopsy (cont.)
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In preparation for a sentinel node biopsy, the patient usually undergoes tests of the blood and urine and a mammogram (an imaging test of the breast that helps determine the location of the tumor) if the procedure is being done for breast cancer diagnosis.
The doctor may advise the patient to stop taking medications such as aspirin, antiinflammatory drugs, anticoagulants (drugs that thin the blood), and dietary supplements (such as ginkgo biloba) for a few days prior to the procedure. The doctor may also recommend that the patient either eat lightly or avoid food and beverages altogether for a certain number of hours (usually eight to 12) prior to surgery.
To prepare for the surgery, the doctor first needs to determine which of the lymph nodes is the sentinel lymph node. The doctor may use one or both of the following methods to locate the sentinel lymph node:
The success rate for locating the sentinel lymph node with an injection of blue dye alone is 82%. The radioactive tracer injection is associated with a 94% success rate. The combination of both carries a 98% success rate, although an experienced surgeon will typically find a node with a single agent in >95% of cases.
Often, a sentinel node biopsy is performed during a lumpectomy or a mastectomy. A lumpectomy is a surgical procedure that involves removing a breast tumor surrounded by a rim of normal tissue. A mastectomy is a surgical procedure that involves removing the whole breast. If the doctor performs one of these other procedures in addition to the sentinel node biopsy, the woman usually receives general anesthesia to prevent pain and awareness during surgery. Occasionally, the woman may receive only local anesthesia, which involves numbing only the area involved in the surgery.
Leigh A Neumayer, MD, MS, FACS
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