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Lumpectomy with Sentinel lymph node Biopsy (Possible Axillary Node Dissection)
Based on the results of your last biopsy your physician is recommending you have a lumpectomy with sentinel lymph node biopsy and a possible axillary node dissection. A lumpectomy is a procedure that preserves your breast, but removes the lump and some normal tissue around it. A sentinel lymph node is often removed and examined for signs of cancer. If the sentinel lymph node is not detected a wider local excision of lymph nodes will be taken (axillary node dissection).
This particular procedure requires that you first be seen in Hartford Hospital Radiology Nuclear Medication department. Here the surgeon may inject a radioisotope; into the subareolar aspect of the breast. The isotope allows the surgeon to detect the sentinel lymph node through a series of x rays taken following injection. In the Operating Room intravenous sedation will be administered by the anesthesiologist and local anesthesia administered by the surgeon to the area of the breast before an incision is made. The surgeon will inject a "blue dye" to identify the sentinel lymph node. Please note this dye may turn your urine blue for 24 hours and skin a blue color that will fade over a period of time (several weeks). Through the incision the sentinel lymph node is detected and tested for cancer. If the sentinel lymph node is positive for cancer other axillary lymph nodes will be removed. If the sentinel lymph node is negative only the sentinel lymph node will be removed. A separate incision will be made for the lumpectomy. Following your stay in the recovery room you will be either admitted to the hospital for an overnight stay or discharged home.
A drain may be placed under your arm for removal of any blood or other fluids that may collect there (see attached educational sheet for care). This will remain in place upon discharge from the hospital and removed during a postoperative appointment with the surgeon. Please allow 3 days for the pathologist to make a definitive diagnosis, although preliminary results may be available earlier.
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