What should you know about sentinel axillary lymph nodes?

Axillary lymph nodes sit in the armpit. Lymph fluid from the breast commonly drains through a pathway to a first node or small group of nodes. During sentinel-node assessment, a surgeon identifies and removes those nodes for laboratory examination rather than automatically removing every node in the armpit.

The result can show whether cancer cells are present in the sampled nodes and helps the team determine stage and further treatment. A negative sample lowers concern about disease in the examined pathway but does not answer every question about the breast tumour. Pathologists may use Immunohistochemistry to look for cell features that are not visible on routine staining.

Ask whether the procedure will be done with breast surgery or as a separate step, how the nodes will be located, and what recovery to expect. The team may discuss a Biopsy, MRI Scan, or other tests when they need more information before surgery. Bring a list of medicines and tell the team about allergies, pregnancy possibility, or previous lymph-node surgery.

After the result, ask whether observation, further surgery, radiotherapy, or systemic treatment is recommended. Chemotherapy may be one part of a wider plan when the tumour and node findings indicate it. Ask about arm movement, wound care, and signs of lymphoedema during recovery.

Contact the surgical team for increasing redness, warmth, drainage, fever, worsening pain, or swelling around the wound. Report new heaviness, tightness, or persistent swelling in the arm, hand, breast, or chest on the treated side. Seek urgent help for severe bleeding, breathing difficulty, fainting, or sudden chest pain.

Ask: Which nodes are being sampled? How will they be located? When will pathology be available? What does a negative or positive result change? Will Immunohistochemistry or Genomic Tumour Profiling be used? Do I need another scan or treatment, and how can I reduce arm stiffness or swelling?