[ PRINT ] [ Printing FAQ ] About OncoLink Editorial Board Sponsors Help See Today's OncoTip Usage Statistics Virtual Classroom Abramson Family Cancer Research Institute "Confronting Cancer Through Art" is an exhibition by people whose lives have been touched by cancer. This week we are featuring artwork by: Jacqueline Kniewasser Pontypool, Ontario Visit the Children's Art Gallery This week's artwork was donated by a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia.

OncoLink FAQ: Sentinel Node Labeling Last Revision Date: Sunday, 14-Feb-1999 13:54:29 EST Copyright © 1994-1999, The Trustees of the University of Pennsylvania This is a response to a question about sentinel node labeling. Question: What is sentinel node labeling? Can it be done AFTER an excisional biopsy of an invasive intra-ductal solid breast tumor or must this be done before the surgery? Thank you, J Li Liu, MD, OncoLink's Editorial Assistant, responds: Dear J, Thank you for your question and interest. A sentinel lymph node is the first lymph node along the route of lymphatic drainage from a primary tumor. Dr. Cabanas first introduced the concept of sentinel nodes in the late 70's. In his studies the first lymph nodes to receive lymphatic drainage from a tumor could be removed by limited surgery and examined to determine whether more extensive lymph node dissection was necessary. Sentinel lymph node biopsy carries lower morbidity and cost than a complete axillary node dissection. Normally the patients would undergo biopsy first to establish tissue diagnosis prior to sentinel lymph node labeling. Negative surgical margins can sometimes be accomplished by biopsy alone depending upon the size of the tumor, the extent of the biopsy, and some technical factors as well. Thirty minutes to a few hours before surgery, technetium-99m sulfur colloid, the labeling agent, is injected at the 3-, 6-, 9-, and 12-o'clock positions into the breast tissue surrounding the primary tumor or biopsy cavity. Some institutions use blue dye in addition to technetium-99m in an attempt to increase sensitivity of the test. Surgeons then identify and remove just one or two lymph nodes (the sentinel nodes) indicated by the uptake of the labeling agent, or dye. These are then sent for pathologic evaluation. While this procedure avoids the morbidity of a full axillary dissection, it relies on the theory that cancer spreads in an orderly progression from the breast tissue into the sentinel node then into other nodes in the axilla. This remains to be proven conclusively. The largest study so far regarding this issue was published on recent The New England Journal of Medicine, Volume 339, Number 14, 1998.

GENERAL DISCLAIMER OncoLink is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through OncoLink should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.

For further information, consult the Editors at: editors@oncolink.upenn.edu