Axillary Sentinel Lymph Node Biopsy

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Lesions clinically less than stage T2, clinically negative nodes, and no metastases
  • Consider for stage T3 lesions, locally advanced tumors, or multicentric cancers.
  • Use cautiously in patients with significant disturbance of the breast.
  • Consider using SLNB alone for aggressive lesions.
CONTRAINDICATIONS
  • Previous SLNB
  • Existing axillary scar
  • Previous radiation (relative contraindication)
  • Palpable or matted nodes
  • Inflammatory breast cancer
EQUIPMENT
  • Scalpel
  • Electrocautery
  • S retractors
  • Appendiceal retractors
  • Long fine tonsils
  • Long sponge sticks
  • Babcock clamps
  • 19F Blake drain
  • 3.0 nonabsorbable suture
  • 4.0 Vicryl running stitch
ANATOMY

Structures to consider with axillary sentinel lymph node biopsy are shown above.


PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Caution the patient against significant arm movement.
  • As soon as the wound is healed, mobilize the patient's arm to regain range of motion.
COMPLICATIONS
  • Blue dye reaction
  • Oxygen desaturation occurs
  • A blue or hot sentinel lymph node cannot be identified in a patient with invasive cancer.
  • Inability to localize an sentinel lymph node in the axilla (requires axillary node dissection)
  • Postsurgical hemorrhage
  • Sensory deficit
  • Nerve damage
  • Frozen shoulder
  • Lymphocele
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