Which statement about sentinel lymph node biopsy is accurate during breast cancer surgery?

• A. The surgeon will biopsy sentinel lymph nodes during your surgery to assess for metastasis.
• B. The surgeon will remove all lymph nodes to prevent metastasis.
• C. Lymph nodes are not evaluated during lumpectomy.
• D. Radioactive seeds are used to assess lymph nodes.

Answer: (A)

The main concept is using sentinel lymph node biopsy to stage breast cancer and guide surgical management while minimizing morbidity. A tracer is injected near the tumor, and the surgeon locates the first lymph node(s) that drain the breast—the sentinel nodes. These nodes are removed and examined for cancer cells during the operation. If sentinel nodes are free of metastasis, there is usually no need to remove additional axillary lymph nodes, reducing risk of lymphedema and nerve injury. If cancer is found in the sentinel nodes, further axillary surgery or other treatments may be considered based on staging. Lymph nodes are commonly evaluated during lumpectomy when sentinel node biopsy is done; it is not accurate to say lymph nodes are not evaluated. Also, this assessment is not done with radioactive seeds; instead a radioactive tracer is used (often with blue dye) to map and identify sentinel nodes.