Sentinel Lymph Node Mapping and Biopsy
What to do before your Sentinel Lymph Node Mapping
Put the cream on
the nipple,
areola, and 1 to 2
inches around
the areola
If the mapping procedure is the day before surgery:
 One Hour before your procedure, apply a thick layer of the numbing cream to the
breast that has the breast cancer. Do not rub it all the way in, leave the thick layer
visible.
 Place a square of plastic wrap from your kitchen on top of the cream and put on
your normal bra. You do not need to tape the plastic wrap down, it will stick to the
cream.
 Take one pain pill One Hour before your procedure. Bring the remaining cream
and pain pills with you to the hospital.
 You will need to have someone drive you to this procedure since you are
taking pain medication.
If the mapping procedure is the same day as surgery: Follow the same directions
as above. If you are also going to the breast center for a Needle Localization that
same day, put the cream on before coming in for the Needle Localization. Bring the
remaining cream and pain pills with you to the breast center.
What is a Sentinel Lymph Node Mapping and Biopsy?
The lymph system is responsible for draining fluid from tissues through tiny channels in your body. It
also filters the fluid through special glands or lymph nodes containing cells that help your body fight infections
caused by bacteria and viruses. In breast cancer, the sentinel lymph nodes are the first nodes that breast fluids
drain to and they are found in the armpit, or axilla. They are about the size of a bean.
Sentinel lymph node biopsy (SLNB) is the removal of the lymph nodes closest to the breast tumor.
Several lymph nodes are removed and looked at under a microscope to see if they have any cancer cells in
them. This information is important for your doctors to know to decide the best treatment for you. Sentinel
lymph node mapping is the procedure done before surgery to find the lymph nodes.
How are the Sentinel Lymph Nodes Found?
Before your surgery, (this will be either the day before or the morning of, your doctor will let you know),
you will go to Sentara CarePlex Hospital so that we can find the sentinel lymph node. You will hear this part of
the procedure called a “sentinel lymph node mapping”. This is how we find the lymph nodes. A doctor from
the radiology department will give you 4 injections of a special substance called a radioactive tracer around
your nipple. A very small needle is used and the injections will take less
than two minutes. This radioactive tracer burns for about 1-2 minutes after
it is injected and can cause some discomfort. Your surgeon’s office will
give you prescriptions for pain pills and numbing cream to put on your
breast before having this procedure done.
While you are asleep during surgery, your surgeon will also inject a
blue dye into your breast. The radioactive tracer and the blue dye will
follow the lymph channels in your breast and lead the surgeon to the
sentinel lymph nodes (lymph nodes closest to your breast). Your surgeon
will then remove the lymph nodes that take up the most radioactive tracer
and blue dye. This is usually 1 to 4 nodes, but may be a few more than
that. In addition, your surgeon will examine the area under the arm for any
other nodes that look or feel abnormal and remove them if needed.
If you are having a lumpectomy, you will end up with an incision on
your breast where the cancer is removed, and a second incision in your
armpit where the sentinel lymph nodes are removed. If you are having a
mastectomy, the lymph nodes will be removed through the same incision
as the breast tissue. Don’t be surprised if you have more discomfort in the
armpit than in your breast after surgery. There are more nerve endings in
the armpit and this causes more sensitivity to this area.
***You may notice blue or green urine the day after surgery. This is from the blue dye. Your
urine should return to normal color within 24 hours.