Sentinel Node Biopsy

I was diagnosed with BC on 24th January this year, I had a mammogram, ultrasound scan both which showed a small lump of 5mm in my breast, when they performed the ultrasound they also scanned my armpit, they performed a needle core biopsy on the lump but no biospy of the lymph nodes, reading some of the posts here, many of you have had both a NCB & SNB at the time of the ultrasound scan, they couldnt see anything visible in the tissue in the area of my lymph nodes on my ultrasound scan, but when I have my lumpectomy on 7th Feb they will perform the SNB then, just wondered if anyone else has found themselves in a similar position having their SNB at the time of their op and the reasons for this.
Thanks in advance

Hi LS1972,
When I was dx in November 2010 I had a mammogram, then got called back for a biopsy of the lump and an ultrasound. They did a needle biopsy of my armpit as well as an ultrasound but not SNB. My lump was huge (45mm) and I had to have chemo to shrink it first. After chemo I went on to have a lumpectomy as the chemo had shrunk the tumour to nothing. It was then that I had a SNB at the same time. My surgeon explained that he would do this whilst I was asleep and then test the SNB and if anything found would do a lymph node clearance at the time. Luckily it was totally clear so no further surgery needed.
I then went on to have rads and Herceptin for 12 months as Her2+.
He never gave me a reason for this - just said that that was how he did it.
Hope this puts your mind at rest.

Hi LS1972,
I was diagnosed with BC in March 2010, had a mammogram, ultrasound and biopsy on the same day. I had a smaller lump (16mm) so I had surgery first: lumpectomy and SNB at the same time. My surgeon told me the same as for SamLee, get rid of the lump, do a sentinel node biopsy, take it away and test it while I was out cold, and if the node showed cancer cells they would clear lymph nodes while I was still on the operating table. However results were clear so I just had the lump removed. I thought it was a really good idea to do both at the same time as I was so ill after the general anaesthetic I wouldn’t have wanted to go through it again in a hurry! For the SNB they injected something with blue dye into the breast while I was waiting to go into theatre (I also had a guide wire put in for the surgery, so it was quite a long day), but nothing that hurt (bit of a sting), although my wee was blue for a while afterwards!

Hi LS,
I think you may be confusing some issues here. A SNB is done at the same time as any operation you may need, for example, your lumpectomy. The surgeon will remove about 3 of your lymph nodes (the sentinel ones) at the same time as the lump. The removed sentinel nodes and the removed lump will then be looked at under a microscope in the Path Lab.

What is sometimes done at the same time as the Triple Assessment (mammogram, ultrasound and if necessary a core biopsy on the lump) is a FNA of the armpit - this is just a simple Fine Needle Aspiration done by the Radiologist after the ultrasound scan. She will have scanned your armpits during the ultrasound scan and must be satified there are no obvious abnormalities. It is only when she thinks there are signs of abnormalities that she will do the FNA. It sounds like you may be lucky.

Good luck on 7th Feb. xxx

Hi LS,

As Lola says, they only biopsy the lymph nodes at the time of ultrasound if they see one that is enlarged, this is not the same thing as a sentinel node biopsy, at the ultrasound scan they’d have no way of knowing which was the sentinel node.

The sentinel node is the one that everything drains through first, the idea behind sentinel lymph node biopsy is that if that node is clear, then it means that the cancer has not spread further and they don’t need to take out the rest of the lymph nodes, meaning fewer side effects for the patient. The sentinel node is identified by injecting a tiny amount of radioactive liquid in to the tissue near the nipple of the affected breast, this drains away through the sentinel node an occasionally in to another 1 or 2 nodes. During the surgery they use a small radiation detector to identify where the sentinel node is and remove it, then test it. If it is negative there is no need to remove any more nodes, if positive they will proceed to full axillary clearance, either during the same surgery, or in the case of the hospital here, at a later date.

Best of luck for the 7th


They also inject a blue dye whilst you are under anaesthetic, to mark the nodes they need to take out. As far as I know, the removal of any more nodes, or Axillary clearance if necessary, is always done in a second operation at a later date. You will probably find other experiences of surger in the ‘undergoing surgery’ thread.
Good luck for 7th Feb. Hugs
pg xx

Hi everyone,
Many thanks for all your helpful replies.
Mrs Sloth…blue wee…!! that will be a whole new experience…thanks for the tip off…I will now officially not panic if my wee is blue…!!
Lola65, yes I was confusing a SNB with the FNA, I’ve read afew posts in which people have had an FNA and was curious as to why I hadnt, the surgeon explained about the isotope injection and testing of the sentinel node while I was having surgery, he said he’d view it there and then and do a full ANC if it was necessary at the time since I have type 1 diabetes and it would save having another op at a later date.
Thanks for your good wishes…I am officially terrified, peomsgalore I will hunt out the undergoing surgery thread and read up on what to expect, hopefully that’ll put me a little more at ease
LS xx