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The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasizing cancer cells from the tumor .
To locate the draining lymph nodes or sentinel lymph nodes from a breast cancer tumour, a Technetium-99m based radiopharmaceutical is common. This may be a nanocolloid or sestamibi . [ 7 ] Although imaging with a gamma camera may also take place, the idea of a small gamma probe is that it can be used to identify lymph nodes (or other sites ...
The concept of sentinel lymph node biopsy in breast surgery is one of the major contributions of Giuliano to modern day breast cancer management. [3] He inherited the idea of sentinel node biopsy from his mentor Morton in early 1990s, who at that time was using the technique for skin melanoma management.
Virchow's nodes take their supply from lymph vessels in the abdominal cavity, and are therefore sentinel lymph nodes of cancer in the abdomen, particularly gastric cancer, ovarian cancer, testicular cancer and kidney cancer, that has spread through the lymph vessels, and Hodgkin's lymphoma. [1]
The lymph nodes located in the axilla area that are affected by breast cancer are called the guardian or sentinel lymph nodes. Lymph nodes are essential to the lymphatic/immune system due to their main function of filtering unrecognized particles and molecules. [ 4 ]
The detection of micrometastases in the sentinel lymph nodes (SLN) is the primary indicator of its spread to the regional lymph nodes, bone marrow, peripheral blood and ultimately to distant metastatic sites, since they are the first of the nodes that cancer would travel to. [3]
The sentinel lymph node biopsy (SLNB) is the standard of care for detecting nodal metastases in cutaneous melanoma patients and has been the most informative prognostic factor to guide subsequent treatment. However, ~85% of patients undergoing this procedure have no evidence of nodal metastasis.
The sentinel lymph node is the first node that drains the tumor, and subsequent SLN mapping can save 65–70% of patients with breast cancer from having a complete lymph node dissection for what could turn out to be a negative nodal basin.