What are Sentinel Lymph Nodes?

Medically reviewed by: Dr. Jay R. Anam

Sentinel Lymph Nodes

Lymph nodes are small masses of tissue with white blood cell content that protects the body against infections. They are also known as lymph glands and are associated with the immune system. The work of the lymph nodes is to filter out the lymph fluid that contains waste products and fluid from the tissues in the body. 

Testing the lymph nodes is effective for planning the treatment plan for cancer and increasing the recovery potential. At times, the cancer cells originate in the lymph nodes, or cancer from other organs spread to the nodes.

What is a sentinel lymph node?

Sentinel lymph nodes are essentially the first lymph node station that cancer cells affect. This occurs in patients who already have a tumour in some part of their body. In many cases, cancer patients have multiple sentinel lymph nodes in their bodies. 

What is a sentinel lymph node biopsy?

SLNB or sentinel lymph node biopsy is a surgical procedure that cancer surgeons conduct to find, examine, and sample the sentinel lymph nodes. They conduct this procedure to see if cancer has spread to the lymph nodes. Once the sentinel node is excised, it is sent to the frozen section. A frozen section is a type of histopathological examination that can determine the presence of cancer in nodes within 15 – 20 minutes. The frozen section is carried out during the surgery.

If cancer has not spread to the lymph nodes, on the frozen section it means no further lymph node removal is necessary. However, if the lymph nodes show cancer presence, doctors need to perform further surgery.

 

What happens during an SLNB?

    Doctors would add a safe radioactive substance or tracer near the tumour of the cancer patient a few hours prior to the biopsy. The surgeon can find the sentinel lymph node(s) afterwards. During the main surgical process, doctors would put the patients under general anaesthesia. This puts the patients to sleep. 

    After the patient is comfortably sleeping, the cancer surgeon in charge would handle the following tasks:

    • Injecting a blue-coloured dye into or around the cancerous part. In many cases, doctors use both the radioactive tracer and dye. 
    • This dye colours the sentinel nodes which allows the oncologist to view the sentinel nodes easily. In case the patient got the radioactive tracer, the doctor would use an Intraoperative gamma detector to locate the sentinel. 
    • Then, doctors do a small cut or incision in the area where the sentinel lymph nodes are present. Approximately, one to three sentinel nodes are identified and excised and sent to the frozen section.

    Related Blog: What To Do If You Find a Lump?

    Sentinel lymph node biopsy works for cancer patients with particular types of cancer whether cancer cells can expand into lymph nodes. It is a surgical process, generally conducted for people with the following cancer types:

    • Melanoma 
    • Breast cancer
    • Head and neck cancer 
    • Cervical cancer
    • Penile cancer 
    • Endometrial cancer

    What are the benefits of SLNB?

    There are multiple notable benefits of conducting a sentinel lymph node biopsy. With this, experts in the field can stage cancers and evaluate the potential risk of other cancer cells moving into the lymphatic cells. This helps determine the extent and severity of the primary cancer types. Also, those who test negative for the presence of cancerous sentinel lymph nodes can avoid further lymph node surgery. This lowers the possible complications of losing lymph nodes as well. 

    Sentinel lymph node biopsy side effects?

    The possible side effects of this procedure are pain, swelling, and or short-term bruising of the area. Particular surgery-related complications like infection or bleeding are also possible.  Also, the diagnosis and potential side effects are not always completely accurate. Statistics show that 5-10% of all cases can appear as false negative. 

    Related Blog: Is Recurrent Breast Cancer Worse?

    What are the possible harms of SLNB?

    Typically, the sentinel lymph node biopsy is a safe surgical process. However, there are risks of complications with the process for cancer patients.

    These include:

    • Infection 
    • Bleeding
    • Bruising or pain at the location of the incision 
    • Minimal risk of lymphedema. 
    • Allergic reaction- mainly to the coloured dye entered into the body

    Conclusion

    Overall, there are multiple ways in which an SLNB procedure is useful, for the diagnosis and treatment of cancer. Experts in the field can verify if there is a presence of cancer and can plan further preventive techniques if cancer has not expanded. It is important to contact your doctor in case you see particular side effects from the surgery.

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      About Author
      Dr. Jay Rashmi Anam

      Surgical Oncologists

      15+

      Year Of Experience

      MMC- 2006031309 (2006)

      Dr. Jay Anam is one of the best surgical oncologists & breast cancer specialist in Mumbai.

      Dr. Jay Anam has Completed his M.Ch. Surgical Oncology training from Tata Memorial Centre. He did his Fellowship in Breast Oncology from Centre Oscar Lambret, Lille, France.

      As a breast cancer specialist, he believes in world-class cancer care for all patients.

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      Facing breast cancer surgery is a brave step, and we know the recovery process may feel overwhelming at times. One aspect of recovery many patients encounter is managing surgical drains.

      While these medical devices play a crucial role in your healing, they can be intimidating at first. But don’t worry. With the right knowledge and tools, you can manage them confidently and focus on feeling better.

      This guide is here to walk patients and caregivers through every step of drain care—from the basics to troubleshooting to emotional support. By the end, you'll feel prepared to tackle this part of your recovery with ease.

      How to Reduce Drainage After Mastectomy?
      Author
      dr-jay-anam-favicon

      Dr. Jay Anam

      Breast Cancer Surgeon and Oncoplasty specialist in Mumbai

      Introduction

      Why are surgical drains important after breast cancer surgery? These small, plastic tubes help remove excess fluids that can build up in your body as you heal. Getting rid of this fluid reduces swelling, prevents complications like infections, and helps your body recover faster.

      We’ll cover everything you need to know, including how to empty and clean your drains, spot signs of infection, manage discomfort, and return to daily life with confidence.

      Understanding Surgical Drains

      To start, it’s helpful to understand what surgical drains are and why they’re used.

      What Are Surgical Drains and Why Are They Necessary?

      After surgery, your body produces fluid as part of its natural healing process. Sometimes, this fluid needs help draining so it won’t pool under the skin. That's where surgical drains come in.

      Types of Drains

      There are a few kinds of surgical drains commonly used:

      • Jackson-Pratt (JP) drain – Often shaped like a small bulb, this popular option collects fluid that you can measure and empty.
      • Hemovac drain – A slightly larger round container, often used for higher drainage needs.

      Your surgeon will determine the best type for you based on your surgery.

      How Long Will They Stay in Place?

      The timeline varies. Most patients have their drains for 7 to 14 days, but it depends on how much fluid they produce. Don’t worry; your doctor will remove them once output slows down.

      Step-by-Step Drain Care Guide

      Drain care is manageable if broken down into steps. Let's cover the essentials.

      How to Empty the Drain Properly

      1. Wash your hands thoroughly with soap before touching the drain.
      2. Unplug the bulb or container, holding it upright.
      3. Carefully pour the fluid into a measuring cup.
      4. Record the amount and time in a log to share with your doctor.
      5. Squeeze the bulb to reset the suction before plugging it back in.

      💡 Tip: Empty the drains 2-3 times a day, or whenever they’re about half full.

      Cleaning & Infection Prevention

      • Gently clean around the drain site with soap and water or antibacterial wipes. Avoid tugging or rubbing the area.
      • Watch for signs of infection, such as:
        • Redness or swelling around the site
        • Fever above 100.4°F
        • Foul odor or colored drainage

      If you notice these, call your doctor.

      Best Sleeping Positions

      Finding a comfortable position can be tricky. Try:

      • Sleeping on your back with pillows under your arms for support.
      • If you’re a side sleeper, place a small cushion around the drains for padding and avoid putting pressure on them.

      💡 Tip: A drain-friendly post-surgery pillow with built-in pockets can make rest easier.

      Showering & Hygiene Tips

      Ask your surgeon if showers are allowed. If so:

      • Cover your drains with a waterproof dressing or use a surgical drain belt.
      • Limit water exposure to avoid infections.

      If showering isn’t an option, stick to sponge baths until your doctor gives the green light.

      Recognizing and Managing Complications

      Sometimes, issues arise. Here’s what to keep an eye on:

      When to Call Your Doctor

      • Drainage suddenly increases or stops altogether
      • Severe pain or swelling
      • Fever or signs of infection

      Dealing with a Clogged Drain

      A frequent issue is a clogged drain. If you notice reduced suction:

      1. Milk the tube by gently squeezing it to dislodge the blockage.
      2. If this doesn’t help, notify your healthcare provider promptly.

      Signs of Seroma (Fluid Buildup)

      Once drains are removed, some patients develop a seroma. Symptoms include swelling, tenderness, or a feeling of liquid under the skin. While many seromas go away on their own, consult your doctor for advice.

      Pain & Discomfort Management

      • Pain is part of recovery, but you don’t have to suffer unnecessarily.

        Medication vs. Non-Drug Relief

        • Use prescribed painkillers as directed.
        • Non-medical options, like a cold compress or heating pad (with your doctor’s approval), can help with aches and stiffness.

        Gentle Exercises

        Simple arm stretches or shoulder rolls can prevent tightness, but avoid anything strenuous. A physical therapist can provide guidance.

        Relaxation Techniques

        Practice deep breathing or try mindfulness exercises to cope with discomfort.

      Diet & Nutrition for Faster Healing

      Fueling your body helps tissues heal faster. Focus on:

      • Protein-rich foods, like lean meats, tofu, beans, and eggs.
      • Anti-inflammatory options, like berries, leafy greens, and nuts.
      • Drink plenty of water every day.
      • Consider supplements, like zinc or vitamin C, but check with your doctor first.

      Physical Activity & Movement Guidelines

      Movement helps, but balance is key:

      • Begin with light stretches or short walks to prevent stiffness.
      • Avoid lifting anything heavier than a few pounds in the first week.
      • Your doctor will guide you on when you can resume driving or house chores.

      💡 Tip: Use a supportive bra to minimize any strain during recovery.

      Emotional & Psychological Support

      Caring for drains can feel isolating. It’s okay to have mixed emotions.

      Coping with Anxiety

      Deep breathing, journaling, or talking to a friend can help manage stress.

      Find Support Groups

      Connect with others who’ve been in your shoes. Online breast cancer recovery forums or local groups can make you feel less alone.

      Mental Health Resources

      Don’t hesitate to reach out to a counselor or therapist to process emotions during your recovery.

      Emotional & Psychological Support

      Caring for drains can feel isolating. It’s okay to have mixed emotions.

      Coping with Anxiety

      Deep breathing, journaling, or talking to a friend can help manage stress.

      Find Support Groups

      Connect with others who’ve been in your shoes. Online breast cancer recovery forums or local groups can make you feel less alone.

      Mental Health Resources

      Don’t hesitate to reach out to a counselor or therapist to process emotions during your recovery.