Lymph Node Testing

Lymph node testing is a very important process in treating breast cancer. This is needed if it is possible that your breast cancer could have metastasized into your lymphatic system. Even if there is no sight of invasion before your surgery it must be evaluated on a microscopic level. 

The stage at which your breast cancer was discovered determines the need for this test.

The sentinel node is the first in the string of many lymph nodes that act as a drainage system for your breast. A doctor may order a test called a 'Sentinel Node Injection' to be done a few hours before your surgery.

This test is usually done by your surgeon or a radiologist. It consists of a small amount of radioactive tracer being injected into your breast. A local anesthetic may be used for this injection, however, not much can be used as it may interfere with how the radioactive agent is absorbed by your lymphatics. This injection is usually done within a few hours of going into the operating room. Patients may experience a burning or stinging sensation at the time of this injection, however, it goes away rather quickly.

Once in surgery, the surgeon uses a special device called a Geiger counter. It detects the radioactive dye's path in the lymphatic system. Once these lymphatic system has been located, the first in line (the Sentinel Node) is surgically removed and immediately sent to the pathology department for analysis.

The results of this test give your surgeon 2 options:

• If positive, the surgeon can perform an axillary node dissection. The purpose of this would be to determine how many other lymph nodes have been involved.
• If negative, the surgeon can rest assured that the rest of the lymphatic system is clear as well.