When diagnosing cancer, different tools are used to determine whether the disease has spread, depending on what type of cancer it is or where it is located in the body. For some gynecological cancers, a relatively new procedure called sentinel lymph node mapping and biopsy has become increasingly important.
Mapping has the advantage of being far less extensive than traditional lymph node removal, meaning it is less risky and allows for quicker recovery for patients. It has also become a standard of care for melanoma, while being used more frequently for cancers of the endometrium, cervix and vulva.
Finding the Sentinel Node
The lymphatic system is a network of vessels and nodes that carry infection-fighting white blood cells and remove waste from cells and tissues. It can also be a conduit for cancer to travel throughout the body.
The sentinel node is the lymph node closest to the tumor, or the node where the cancer is likely to spread first. In mapping, dye or radio-tracers are injected in a site near the primary cancerous tumor to identify that sentinel node.
Once it is found, it is biopsied. The technique is far less extensive than surgically removing all adjacent lymph nodes – the practice long held to find out if cancer has metastasized.
The technique can be a game-changer for many women. Traditional lymph node removal brought with it risks of bleeding, nerve injury, infection and lymphedema – an uncomfortable accumulation of fluid that results in swelling of the arms or legs. Sentinel lymph node mapping and biopsy result in a considerably shorter recovery time.
The results of the biopsy determine if and what further treatment may be necessary. If cancer has spread to the sentinel lymph node, it may also be present in nodes nearby and possibly other organs. If the sentinel node is clear of cancer, the mapping helps us avoid removing more lymph nodes.
This is just one example of how medical science is continually improving treatments and survival rates for patients with gynecologic cancers. New immunotherapy and other targeted medications have helped improve survival rates for patients. We're making progress every day.
Dr. Schiavone introduced the use of sentinel lymph node mapping to stage cervical, endometrial and vulvar cancers at Holy Name Medical Center. She has completed a number of clinical projects focusing on sentinel lymph node mapping, the reduction of surgical site infections, and robotic surgery for gynecologic malignancies.
To learn more about the center’s gynecologic oncology services for the diagnosis, treatment, and management of gynecologic cancers and benign tumors, visit holyname.org/cancercare/GynecologicOncology.