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Sentinel lymph node scintigraphy

A scintigraphy of the sentinel lymph node (Sentinel Lymph Node) is a nuclear medical examination, which is used to detect the lymph node, which will be reached first by the lymphatic fluid of a malignant tumour. Hereto, a small amount of a low-radiation marker substance is administered and it accumulates in the lymphatic system on the way to the sentinel lymph node and emits radiation, which is subsequently recorded with a gamma camera as an image (scintigram). This allows to locate the sentinel lymph node.

Thousands of lymph nodes are connected by the lymphatic system. They form part of the body’s immune system. The lymph nodes are constructed like a filter which clears particles from the lymphatic fluid. Tumour cells can disseminate from a malignant tumour and be transported in the lymphatic system. The first lymph node reached by these cells stops them, enabling them to develop to a lymph node metastasis. This first lymph node is called the sentinel lymph node or “sentinel”. If this lymph node contains tumour cells it is very probable to find further metastases in the surrounding. However, if the sentinel lymph node is free from tumours, it is unlikely to find further metastases.

The scintigraphy of the sentinel node is especially used in breast cancer (breast carcinoma) and malignant melanoma. Prior to a tumour surgery, the sentinel lymph node is made visible and marked for removal. If it turns out that the sentinel lymph node contains no tumour cells, it can be assumed that all other lymph nodes are healthy/ free from tumour cells. By the targeted removal of the sentinel lymph node, most patients are spared from the removal of unaffected / healthy lymph nodes.

 

Examination procedure

The examination is usually done on the day of the surgery. First, a small amount of a low-radiation marker substance is injected into the area of the tumour. The substance is tracked her way through the lymphatic system to the sentinel lymph node by a gamma camera. This procedure takes a few minutes. The first lymph node reached by the substance (“the sentinel”) is marked on the patient’s skin.

The substances used are very well tolerated; allergic reactions are not known. The radiation load is low and quickly degraded.

A few hours later, the tumour and sentinel lymph nodes are removed surgically.

 

Preparation and time

No special preparation is required and you may have had something to eat during the day. You are also allowed to take your medication as usual.

The examination takes approximately one and a half hours.

Please do not hesitate to contact us, if you have any further questions!