Carenotes > Sentinel Lymph Node Breast Biopsy (Inpatient Care)

Sentinel Lymph Node Breast Biopsy

WHAT YOU SHOULD KNOW:

• A sentinel (SEN-tin-el) lymph node breast biopsy is also called a SLN breast biopsy. This procedure is done to check if breast cancer has spread. In breast cancer, many abnormal cells collect in the breast where they form the original, or primary, tumor. Abnormal cells may break away from this tumor and be carried to other parts of the body, which is called metastasis. These cells may pass through lymph vessels and lodge in the lymph nodes. Lymph nodes are groups of lymph tissue that contain lymph fluid. Lymph fluid contains lymphocytes, a type of white blood cell (WBC), that helps fight infection and disease. Lymph nodes may be found in your axilla (armpits), neck, along the sides of your breast bone, below your collarbone, and groin.
  
  
• With a SLN breast biopsy, caregivers check and remove sentinel lymph nodes. The sentinel lymph nodes are the first lymph nodes where cancer is likely to spread from the primary tumor. A weak radioactive substance, a blue dye, or a combination of these is used to locate sentinel lymph nodes. The dye stains the lymph tissue a bright blue so it can be seen. When staining is present, caregivers will remove one or more lymph nodes and send them to a lab for tests. An SLN breast biopsy may also be able to tell how much the breast cancer has spread.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Problems may happen during this procedure, such as you may have trouble breathing or bleed too much. Your lungs, heart, blood vessels, or nerves may be injured, which may lead to more surgery to repair them. After the procedure, you may pass green-colored urine because of the blue dye. Your breast skin may also turn blue for a short time. You may get an infection. Even if you have the procedure, there is no guarantee that the breast cancer will not spread. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.
  
  
• Without a SLN breast biopsy, you may need to have a different procedure. This procedure removes all of the lymph nodes near the tumor and requires larger and more incisions. It may also cause excess fluid to collect in your arm, which causes your arm to swell. If you chose not to have a SLN breast biopsy, cancer may spread to other parts of your body.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Anesthesia: Your caregivers will decide which type of anesthesia medicine is best for you.
  
  
  • Local anesthesia: This is medicine to make you more comfortable during your procedure or surgery. It is a shot of medicine put into the skin. It is used to numb the area and dull your pain. You may still feel pressure or pushing during the procedure or surgery after you get this medicine.
    
    
  • General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

During your procedure:

• Caregivers will check your breast and axilla by touching them in different locations and comparing both sides. Your chest, axilla, and abdomen will be cleaned with soap and water. Sheets will be put over you to keep the procedure area clean. You may be given a local or general anesthesia to make you comfortable during the procedure.
  
  
• Caregivers will inject a radioactive substance, blue dye, or both near the tumor. Your caregivers will then use a scanner or probe to find the SLN that contains the dye. When staining is present in the SLN, an incision (cut) is made through your skin overlying the SLN. This SLN is removed and checked for cancer cells. If cancer is found, one or more lymph nodes are usually removed during the biopsy procedure. The incision is then closed with stitches and covered with bandages to help prevent infection and control bleeding.

After your procedure: You may be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. When caregivers see that you are OK, you may be allowed to go home. If caregivers want you to stay in the hospital, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry. A caregiver may remove the bandages soon after your procedure to check the procedure area. Ask your caregiver for more information about ways to prevent bleeding and take care of your incision.

• Activity: Do not get out of bed until your caregiver says it is OK. Your caregiver may help you get out of bed to walk. This is to make sure that you are walking OK. If you feel weak or dizzy, sit or lie down right away. Then call your caregiver.
  
  
• Diet: If general anesthesia was used for your procedure, you may be able to eat when bowel sounds (stomach growling) are heard. You caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be given ice chips at first, and then liquids such as water, broth, juice, or soda pop. If you do not have problems after drinking liquids, caregivers may then let you eat solid food.
  
  
• Medicines: You may need any of the following:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Monitoring: Caregivers may check for pulses on your arms or wrists. This helps caregivers learn if you have problems with blood flow after your procedure. You may also have any of the following:
  
  
  • Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Sticky pads are placed on your chest or different parts of your body. Each pad has a wire leading to a small portable box (telemetry unit), or to a TV-type screen. This lets caregivers see a tracing of the electrical activity of your heart. The heart monitor may help caregivers see problems with the way your heart is beating. Do not remove any wires or sticky pads without asking your caregiver first.
    
    
  • Intake and output: Your caregivers may need to know the amount of liquid you are getting. They may also need to know how much you are urinating. Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Certain foods also contain liquid. You may need more or less liquid each day. Ask your caregiver how much liquid you should have each day. Ask caregivers if they need to measure or collect your urine before you dispose of it.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.