What is a sentinel lymph node?

www.breastcancer.org explains it well:

The dictionary defines "sentinel" as a guard, watchdog, or protector. Likewise, the sentinel lymph node is the first node "standing guard" for your breast. In sentinel lymph node dissection, the surgeon looks for the very first lymph node that filters fluid draining away from the area of the breast that contained the breast cancer. If cancer cells are breaking away from the tumor and traveling away from your breast via the lymph system, the sentinel lymph node is more likely than other lymph nodes to contain cancer.

When I was diagnosed with breast cancer my head was spinning when my surgeon offered me to participate in a clinical trial. The trial would put women in two groups. One would have just the sentinel node removal and the other group would have a full axillary dissection.

I felt a bit guilty declining the offer to participate in a clinical trial, but I know that I made the right decision for me. First, the procedure was relatively new. I opted for the sentinel node removal plus a full axillary dissection, not just the sentinel node removal on its own. The trial wanted to find out if just taking the sentinel node, being that is turns out in pathology to be cancer free, would prove that other higher lymph nodes were also clear of cancer.

I wasn't willing to take this risk. I wanted as many lymph nodes out that they could find. I ended up with four sentinel nodes and one was positive for metastatic carcinoma. The other 9 higher up lymph nodes were clear.

This brings me to an article I read in Reuters Health, it says removing three sentinel nodes might not be enough. Women should have all sentinel nodes removed. When the die test or radioactive test is done to pinpoint the sentinel nodes, it is not unusual for women to have different numbers of them.

A report in the May Archives of Surgery states that all sentinel nodes should be removed to reduce the risk of false-negative results.

My take home message on this post is that if you are diagnosed with breast cancer and are told these medical terms and options, do some research to know what procedure is right for you. Ask many questions to your surgeon and if you do opt for only the sentinel node biopsy -- make sure to ask this important question -- How many times have you performed the sentinel node procedure? This is important because you need someone that does this often and is skilled in finding the right nodes to remove and biopsy.