Lymph Nodes

The information on axillary lymph nodes condition is essential to plan the breast cancer therapy. Before starting the treatment, it is crucial to know the size of the tumor in centimeters (cm- T), if the lymph nodes are compromised or not (N) and if there is metastasis in another distant organs (M).

Information on the lymph nodes condition is obtained through the careful examination of the clavicle supraclavicular fossae and axillary region.

Once there is no compromising suspicious in the clinic exam, the clinic classification is N0.

Besides the clinical information, it is necessary to have the histological information, that is, that the lymph nodes are microscopically examined and the pathologist describes the non- observation of tumor cells in it, and there can be a disagreement of up to 30% between the clinic exam and the histopathological analysis.

The sentinel lymph node technique is the way employed to better identify the lymph nodes impairment, most accurately and with less damage to the patient.

This is an ink injection to the breast, which can be blue, or a radioactive marker or both. They go into the breast lymph stream and drain to the first lymph node or the first axillary lymph node group.

The blue technique can identify, at the axillary region, one or more lymph nodes in blue. The radioactive ink can identify through an equipment, called Gama Probe, the capture of the technician is expressed in numbers and through the sound sign emission.

Once the sentinel lymph node is identified, it is removed and sent to the pathologist to be examined, and he/she informs whether it is impaired or not.

Nowadays, it is not routinely recommended to remove completely the axillary lymph nodes, except in the cases where there is a proven clinic or histological mass impairment of the lymph nodes, or that three or more lymph nodes are impaired, or even impaired lymph nodes in patients that will not have radiation therapy after surgery.

These s made possible to have better information with less damage to the patients.