![]() ![]() ![]() Is SLNB used to help stage all types of cancer? A false-negative biopsy result gives the patient and the doctor a false sense of security about the extent of cancer in the patient’s body. A false-negative biopsy result-that is, cancer cells are not seen in the sentinel lymph node even though they have already spread to regional lymph nodes or other parts of the body.Skin or allergic reactions to the blue dye used in SNLB.Difficulty moving the affected body part.Numbness, tingling, swelling, bruising, or pain at the site of the surgery, and an increased risk of infection.Seroma, or a mass or lump caused by the buildup of lymph fluid at the site of the surgery.Very rarely, chronic lymphedema due to extensive lymph node removal may cause a cancer of the lymphatic vessels called lymphangiosarcoma. In addition, there is an increased risk of infection in the affected area or limb. In the case of extensive lymph node removal in an armpit or groin, the swelling may affect an entire arm or leg. There is less risk with the removal of only the sentinel lymph node. The risk of lymphedema increases with the number of lymph nodes removed. Lymphedema may cause pain or discomfort in the affected area, and the overlying skin may become thickened or hard. This disrupts the normal flow of lymph through the affected area, which may lead to an abnormal buildup of lymph fluid that can cause swelling. During lymph node surgery, lymph vessels leading to and from the sentinel node or group of nodes are cut. Certain technical aspects nevertheless influence these performance measures, and are addressed in the report.All surgery to remove lymph nodes, including SLNB, can have harmful side effects, although removal of fewer lymph nodes is usually associated with fewer side effects, particularly serious ones such as lymphedema. In experienced hands, it generally yields high identification rates and has a low risk of false negatives (1 - negative predictive value). In the light of available data, AETMIS considers that sentinel node biopsy is a proven technique in terms of feasibility and diagnostic accuracy. The CEPO therefore asked AETMIS to conduct a systematic review of the validity of current evidence on the technical aspects of sentinel node biopsy in breast cancer treatment with a view to providing appropriate guidance on this medical procedure in Québec. In this context and according to the high incidence of breast cancer, the Comité de l’évolution des pratiques en oncologie (CEPO) chose to address this issue in order to provide a better framework for medical practices in Québec in this field. Using sentinel node biopsy would in consequence compromise less the quality of life of those affected by breast cancer. This technique is associated with non-negligible postoperative morbidity, however. In some breast cancer cases, it can replace axillary dissection, a traditionally used technique that involves the removing of 15 or so lymph nodes from the axilla for anatomical pathology examination. Among those surgical techniques, there is sentinel lymph node biopsy or sentinel node biopsy. Therefore, patients are more often eligible to less invasive surgeries. ![]() Currently, with population screening mammography and improved imaging techniques, breast cancer is diagnosed at earlier stages and with a lower risk of lymph node invasion, the most significant prognostic factor in early-stage breast cancer. In Québec, about 6000 women will be diagnosed in 2009 with breast cancer, which is the most frequent cancer site amongst women. Sentinel Lymph Node Biopsy in Breast Cancer Treatment : Technical Aspects ![]()
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