تعريف
A sentinel lymph node biopsy is the removal and testing of specific lymph node tissue called sentinal nodes. The sentinal nodes are the lymph nodes to which cancer would spread first.
أسباب هذا الإجراء
This biopsy is done to determine if cancer cells have spread from the tumor to nearby lymph nodes. Cancer often spreads from the tumor to the nearest lymph node or nodes. These lymph nodes are called the sentinal nodes. It is important to understand that the sentinel node will probably be the first one to get cancer if the cancer has spread. For example, the sentinal nodes in سرطان الثدي are often found in the armpit.
هذا biopsy is often done during cancer-removal surgery or prior to surgery. Sentinel node biopsy is part of the staging process. Staging is an attempt to determine how much the cancer has spread away from the original tumor.
المضاعفات المحتملة
Complications are rare. But no procedure is completely free of risk. If you are planning to have this biopsy, your سيقوم الطبيب بمراجعة القائمة of possible complications. These may include:
- العدوى
- Bleeding or bruising
- تندب
- Nerve damage and chronic pain
- Allergy to dye
If the lymph nodes are removed, there is an increased risk of the following:
- Delayed wound healing
- Additional pain
- Lymphedema—a condition in which fluids collect under the skin causing swelling
بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:
- السمنة
- Recent or long-term illness
- التدخين
- سوء التغذية
- Use of certain medicines
- اضطرابات النزيف
ما يمكن توقعه
قبل الإجراء
Your doctor will do a physical exam. The cancerous tissue will be biopsied. Tests may include the following:
- تحاليل الدم
- اختبارات البول
- A mammogram, in cases of breast cancer
- الاشعة المقطعية
- تصوير الرنين المغناطيسي
التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- مميعات الدم
Prior to the procedure, you should also:
- تناول وجبة خفيفة في الليلة السابقة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.
- رتب لتوصيلة من وإلى المستشفى.
التخدير
Depending on the location of the lymph node, you may be given one of the following:
- General anesthesia —You will be asleep.
- Local anesthesia—The area will be numb.
- Regional anesthesia—An area of your body will be numb.
وصف الإجراء
A blue dye, and often a radioactive tracer, will be injected into the area where the tumor is. It may be done several hours before surgery. The dye and tracer will travel from the tumor area to the sentinal nodes. This will help identify which nodes are the sentinel lymph nodes. A small incision will be made. The sentinel node(s) will be removed. The removed node will be checked for cancer cells. If cancer is found, the rest of the lymph nodes in that area will be removed.
If cancer is not seen in the sentinel node, it is unlikely that the cancer has spread to the other remaining lymph nodes. The other lymph nodes are not removed.
كم من الوقت سيستغرق ؟
The biopsy takes about 30-60 minutes. عملية جراحية لإزالة the entire cancer takes longer.
هل ستسبب الالم؟
Anesthesia prevents pain during surgery. Pain medicines are given during recovery.
رعاية ما بعد العملية
The result of the sentinel lymph node biopsy determines if additional lymph nodes need to be removed. It can also help determine the severity of your cancer.
Be sure to follow your doctor’s instructions . Keep the surgical area clean and dry. Ask your doctor about when it is safe to shower, bathe, or soak in water.
If you develop complications from lymph node surgery, you will need to take some special precautions. Discuss these precautions with your doctor.
استدعاء الطبيب
بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
- If lymph nodes were removed: redness, warmth, swelling, stiffness, or hardness in the extremity
- Dark or swollen fingers and toes
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which last for more than two days after discharge from the hospital
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- سعال أو ضيق في التنفس أو ألم في الصدر
- أعراض جديدة غير مبررة
إذا كنت تعتقد أن لديك حالة طارئة ، فاتصل بالمساعدة الطبية على الفور.