Sentinel node biopsy: fluorescence in oncologic surgery
Sentinel lymph node biopsy (SLN) is an innovative technique that allows the identification of metastasis in endometrial, cervical, and vulvar cancer in early stages , helping to define the diagnosis, the stage of the disease, and the appropriate treatment.
The Gynecologic Oncology Unit at the Women's Unit is led by Dr. Álvarez Bernardi , an expert in minimally invasive fluorescence-guided surgery . Dr. Álvarez has explained the fundamentals and advantages of using fluorescence for sentinel lymph node biopsy (SLNB ) in an article published on the Ruber International website.
What is a BGC?
When cancer cells break away from the primary tumor during the development of cancer, they can reach the lymphatic vessels and become trapped in nearby lymph nodes. Lymph nodes play a vital role in the body's immune response and defense against infections.
Thus, a sentinel lymph node biopsy aims to identify and examine the first lymph node to which the tumor drains , known as the sentinel lymph node. The theory is that, based on the concept that the sentinel lymph node is the first to receive any cancer cells that may have spread, identifying it and confirming that it is free of these cells suggests that the other lymph nodes are likely free of metastasis.
For this reason, identifying and evaluating the sentinel lymph node is essential to determine the stage of the cancer and establish a treatment plan.
Fluorescence-guided sentinel node biopsy
To perform fluorescence-guided sentinel lymph node biopsy (SLNB), an indocyanine green dye is administered locally or intravenously before surgery . This dye travels to the lymphatic system. Using a special intraoperative imaging system, the fluorescence is identified, allowing for precise visualization of the sentinel lymph node.
Once identified, it is removed for analysis. If the biopsy is negative for metastasis, the tumor is limited to the organ where it originated.
This technique is used depending on the type and stage of gynecological cancer. However, it is generally recommended for high-risk endometrial, cervical, and vulvar cancers.
Benefits of performing a BGC with fluorescence
Using fluorescence imaging increases the accuracy of sentinel lymph node location, reducing false negatives. It also reduces the risks associated with radioactivity. Furthermore, allergic reactions are very rare, making the overall risk of using this technique very low.
You can read the full article on Fluorescence-Guided Sentinel Lymph Node Biopsy on the H. Ruber International website.
Related articles
- Endometrial cancer: interview with Dr. Álvarez Bernardi
- Gynecological cancer: the most common, risk factors, and treatments
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized department in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person appointment with top specialists.
