Sentinel Lymph Node Biopsy (SLNB)

Sentinel Lymph Node Biopsy (SLNB) is a minimally invasive surgical procedure used to determine whether cancer has spread beyond the primary tumor into the lymphatic system. The “sentinel” lymph node is the first lymph node (or group of nodes) that drains lymph from the area of the tumor. If cancer cells are going to spread, they are most likely to reach this node first.

SLNB is most commonly performed in cases of breast cancer and melanoma, and increasingly in select cases of other cancers. It helps oncologists assess cancer stage more accurately and decide whether further lymph node removal is necessary.

This technique allows for precise staging with minimal tissue removal, reducing the risk of complications such as lymphedema (swelling due to fluid buildup).

Signs & Symptoms That May Indicate the Need for SLNB

While SLNB is not used for diagnosis of cancer itself, it is recommended after cancer is confirmed—especially in:

  • Early-stage breast cancer

  • Malignant melanoma

  • Suspicious skin lesions with evidence of spread

  • Head and neck cancers (in selected cases)

  • Tumors where lymphatic spread is suspected but not yet proven

Symptoms prompting evaluation may include a known cancerous lump, changes in the skin or breast, or findings from imaging or biopsy that suggest possible lymphatic involvement.

Diagnostic & Surgical Procedure

Dr. Syed Hassanujjaman follows a systematic, evidence-based approach to SLNB:

  1. Preoperative Imaging: Includes ultrasound, MRI, or PET-CT to identify lymph node involvement.

  2. Injection of Tracer: A radioactive substance and/or blue dye is injected near the tumor site.

  3. Sentinel Node Identification: During surgery, specialized equipment is used to locate the first lymph node(s) that absorb the tracer.

  4. Biopsy: These sentinel nodes are surgically removed and sent for detailed pathological examination.

  5. Postoperative Planning: If cancer is not found in the sentinel node(s), further lymph node removal is usually unnecessary. If positive, further treatment is planned accordingly.

This highly targeted technique provides vital staging information with minimal discomfort or side effects.