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.
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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.
Frequently Asked Questions
What is a lymph node biopsy and why is it performed for breast cancer?
A lymph node biopsy removes and examines one or more lymph nodes to check whether breast cancer has spread beyond the breast. At Bedford Breast Center, this step is a routine part of accurate staging, helping our surgeons build the most effective treatment plan for each patient.
How do you know if breast cancer has spread to the lymph nodes?
The only definitive way to know is by testing the lymph nodes directly, since imaging alone cannot confirm microscopic spread. Bedford Breast Center's team checks the axillary lymph nodes, the first-place breast cancer typically travels, to determine whether cancer has moved beyond the breast tissue.
What is the difference between a sentinel lymph node biopsy and full lymph node removal?
A sentinel lymph node biopsy removes only the first node (or nodes) that cancer would reach first, offering a far less invasive way to check for spread. Full axillary lymph node removal, by contrast, takes out a larger group of nodes and is generally reserved for cases where the sentinel node already tests positive.
Is a sentinel lymph node biopsy painful?
Most patients feel manageable discomfort rather than significant pain, since the procedure is performed under anesthesia and involves a small incision. Bedford Breast Center's surgeons tailor pain management to each patient for a smooth, comfortable recovery.
How long does it take to recover from a lymph node biopsy?
Recovery from a sentinel lymph node biopsy alone is typically quick, with most patients returning to light activity within a few days. When the biopsy is performed alongside a lumpectomy or mastectomy, recovery time follows the timeline of that larger procedure.
What happens if a lymph node biopsy comes back positive for cancer?
A positive result means cancer has been found in the sentinel node, which typically leads to chemotherapy being added to the treatment plan and may prompt additional lymph node evaluation. Bedford Breast Center's all-encompassing approach means the same team guiding your diagnosis can seamlessly coordinate the next phase of treatment, including port placement for chemotherapy if needed.
Does a lymph node biopsy leave a scar?
Yes, but it is typically small and well-hidden, since the procedure only requires a 1-2 inch incision in the armpit. We place incisions carefully along natural creases whenever possible to minimize visible scarring.
Will I need chemotherapy or radiation after a lymph node biopsy?
That depends on the results. If cancer is found in the sentinel node, chemotherapy is generally included in the treatment plan, while radiation needs are determined separately based on the type of breast surgery performed.
How is a lymph node biopsy performed during a lumpectomy or mastectomy?
Surgeons typically perform the sentinel lymph node biopsy during the same operation as the lumpectomy or mastectomy, using a single anesthesia session for both procedures. Bedford Breast Center's surgeons plan the combined approach in advance, so patients know exactly what to expect going into surgery.
How accurate is a sentinel lymph node biopsy at detecting cancer spread?
Sentinel lymph node biopsy is highly reliable, since the sentinel node is the first and most likely site for cancer to appear if it has spread. False negatives are uncommon, and our experienced surgical team follows established protocols to maximize accuracy.
Our world-class facility serves patients from Los Angeles throughout Greater Los Angeles, including Santa Monica, Glendale, Malibu, and Beverly Hills. To learn more, call us at
(310) 278-8590 or contact us using the online form to schedule an appointment.
