![]() ![]() A meta-analysis of 71 studies with data from 25,240 patients found that the risk of regional lymph node recurrence in patients with a negative SLNB was 5% or less ( 8).įindings from the Multicenter Selective Lymphadenectomy Trial II (MSLT-II) also confirmed the safety of SLNB in people with melanoma with positive sentinel lymph nodes and no clinical evidence of other lymph node involvement. Research indicates that patients with melanoma who have undergone SLNB and whose sentinel lymph node is found to be negative for cancer and who have no clinical signs that cancer has spread to other lymph nodes can be spared more extensive lymph node surgery at the time of primary tumor removal. What has research shown about the use of SLNB in melanoma? After extended follow-up, the two groups of women had similar 10-year overall survival, disease-free survival, and regional recurrence rates ( 7). All of the women were treated with lumpectomy, and most also received adjuvant systemic therapy and external-beam radiation therapy to the affected breast. Patients were randomly assigned to receive SLNB only or to receive ALND after SLNB ( 6). The other trial included 891 women with tumors up to 5 cm in the breast and one or two positive sentinel lymph nodes. The researchers found no differences in overall survival or disease-free survival between the two groups of women. Those women in the two groups whose sentinel lymph node(s) were negative for cancer (a total of 3,989 women) were then followed for an average of 8 years. In one trial, involving 5,611 women, researchers randomly assigned participants to receive just SLNB, or SLNB plus ALND, after surgery ( 5). Two NCI-sponsored randomized phase 3 clinical trials have shown that SLNB without ALND is sufficient for staging breast cancer and for preventing regional recurrence in women who have no clinical signs of axillary lymph node metastasis, such as a lump or swelling in the armpit that may cause discomfort, and who are treated with surgery, adjuvant systemic therapy, and radiation therapy. However, because removing multiple lymph nodes at the same time increases the risk of harmful side effects, clinical trials were launched to investigate whether just the sentinel lymph nodes could be removed. Is SLNB used to help stage all types of cancer? A false-negative biopsy result gives the patient and the doctor a false sense of security about the extent of cancer in the patient’s body. A false-negative biopsy result-that is, cancer cells are not seen in the sentinel lymph node even though they have already spread to regional lymph nodes or other parts of the body.Skin or allergic reactions to the blue dye used in SNLB.Difficulty moving the affected body part.Numbness, tingling, swelling, bruising, or pain at the site of the surgery, and an increased risk of infection.Seroma, or a mass or lump caused by the buildup of lymph fluid at the site of the surgery.Very rarely, chronic lymphedema due to extensive lymph node removal may cause a cancer of the lymphatic vessels called lymphangiosarcoma. In addition, there is an increased risk of infection in the affected area or limb. In the case of extensive lymph node removal in an armpit or groin, the swelling may affect an entire arm or leg. ![]() There is less risk with the removal of only the sentinel lymph node. The risk of lymphedema increases with the number of lymph nodes removed. Lymphedema may cause pain or discomfort in the affected area, and the overlying skin may become thickened or hard. This disrupts the normal flow of lymph through the affected area, which may lead to an abnormal buildup of lymph fluid that can cause swelling. During lymph node surgery, lymph vessels leading to and from the sentinel node or group of nodes are cut. All surgery to remove lymph nodes, including SLNB, can have harmful side effects, although removal of fewer lymph nodes is usually associated with fewer side effects, particularly serious ones such as lymphedema. ![]()
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