Lymph Node Biopsy

At our Beverly Hills breast center, our dedicated breast surgeons perform lymph node biopsy for our Los Angeles-area patients to determine if cancer has spread beyond the breast. This essential procedure helps us pinpoint the exact stage of the cancer, guiding our next treatment steps. While cancer contained in the breast is seen as more favorable, it can be reassuring to know that axillary lymph node involvement is treatable.

What Is Lymph Node Biopsy?

The axillary lymph nodes are generally the first place where breast cancer spreads. These lymph nodes in the armpit are always checked to determine whether the cancer has spread outside the breast.

Instead of removing all the axillary lymph nodes, as was done in the past, we now minimize the surgery’s invasiveness by checking the cancer’s first draining lymph node, or the “sentinel” lymph node.

How Is a Lymph Node Biopsy Performed?

A blue dye is administered by the breast surgeon at the start of surgery to enable identification of the sentinel lymph node. A radioactive solution may also be injected before surgery to assist the identification process further. The solution is gathered by the lymphatic system and delivered to a single or a few axillary lymph nodes.

During the surgery, a small incision is made in the armpit (in a cosmetically favorable place, using a natural crease), and the sentinel lymph node is identified. It is then gently removed and sent to pathology. No further nodes are removed if the sentinel lymph node is negative for cancer. If the result is positive, the surgeon will remove the other involved nodes to render the patient cancer-free.

If a mastectomy patient has more than 3 positive lymph nodes, radiation is generally recommended in addition to chemotherapy. Understanding exactly which nodes are involved with the tumor is critical to a successful lymph node biopsy because treatment decisions will be based on this information.

Breast preserving surgery, called lumpectomy, is done when possible unless the patient decides to have a complete mastectomy. In all breast-preserving surgery, radiation is recommended. If the sentinel lymph node biopsy is positive for cancer, chemotherapy will be included in the treatment.

Visit medlineplus.gov to learn more about how lymph node biopsies are performed.