What are the alternatives? | Lymph node biopsy

What are the alternatives?

Before a lymph node biopsy is performed, imaging should always be performed. In many cases, this can already provide information about the cause of an enlargement of the lymph nodes. However, if there is a suspicion that a tumor has spread into the lymph nodes, a biopsy is the only method to confirm this suspicion. Since the biopsy and its result also have consequences for further therapy, it should be performed.

By localization

Sentinel lymph nodes, also called sentinel lymph nodes, are the first lymph nodes in the drainage area of a tumor. They are usually the first to show metastases (daughter tumors). The sentinel lymph node biopsy is performed primarily for breast cancer, but also for other types of cancer.

Here, the sentinel lymph node is first visualized with the help of contrast medium and then exposed and removed. This lymph node is then sent to the pathology department using the so-called rapid section procedure. After about 20-30 minutes, the surgeon receives the results of the examination.

If the lymph node is affected, further lymph nodes in the drainage area are removed. However, if the sentinel lymph node is free of tumor cells, this means that the lymph nodes in the further drainage area are also tumor-free. Especially in the area of the neck there are countless lymph nodes.

These can swell quickly, e.g. in the context of an infection of the upper respiratory tract.However, if a lymph node is suspicious, the lymph node biopsy can usually be performed under local anesthesia. This is because the lymph nodes in the neck are relatively close to the surface. They can be easily visualized with the help of an ultrasound machine and the subsequent biopsy usually takes only a few minutes.

Tumors that form daughter tumors in the lymph nodes of the neck are mainly tongue and throat cancer. Also in the groin, the lymph nodes are relatively close to the surface and can usually be removed under local anesthesia. Lymph node swelling in the groin area can also have harmless causes such as an infection.

Behind the swelling, however, a malignant lymph node cancer (lymphoma) can also be located. If malignant swelling is suspected, a lymph node biopsy should be performed in the groin to confirm or disprove the suspicion. Swelling of lymph nodes in the armpit can also have harmless causes such as an infection in the area of the hands or arms.

However, one cause can also be breast cancer. Here, the lymph nodes are usually enlarged without pain. A lymph node biopsy in the armpit can be used to find out if there really is cancer. If breast cancer has already been diagnosed, a sentinel lymph node biopsy can also be used to find out whether the cancer has already spread to the lymph nodes in the armpit.