Two NCI-sponsored randomized phase 3 clinical trials have shown that SLNB without ALND is sufficient for staging breast cancer and for preventing regional recurrence in women who have no clinical signs of axillary lymph node metastasis, such as a lump or swelling in the armpit that may cause discomfort, and who are treated with surgery, adjuvant systemic therapy, and radiation therapy. However, because removing multiple lymph nodes at the same time increases the risk of harmful side effects, clinical trials were launched to investigate whether just the sentinel lymph nodes could be removed. 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. Further work is required to ascertain SLN biopsy sensitivity prior to its routine use in the clinic for multicentric and multifocal disease.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. SLN biopsy may have a role after neoadjuvant chemotherapy, sparing some women from axillary node dissection. However, there is evidence that immediate axillary surgery for operable, clinically node-negative breast cancer provides no survival benefit and may be unnecessary for many women. ![]() ![]() There are no sufficiently robust predictive tumor features to prevent completion axillary dissection in these cases. Controversies remain in several specific clinical situations, including management of the axilla following detection of a positive SLN. SLN biopsy is not used where there has been previous axillary or breast radiotherapy or surgery, locally advanced or inflammatory disease and stage IV disease. Staging of the axilla in breast cancer is used to predict prognosis and in planning adjuvant treatment. SLN biopsy has become a mainstay of breast cancer management and is used when the axilla is clinically clear of disease. The sentinel lymph node (SLN) is the first lymph node to receive lymphatic drainage from a tumor.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |