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Sentinel node biopsy tests the first lymph node the breast drains into, instead of removing them all. It is carried out by Dr Swapnil Sharma, MBBS, MS, FMAS, DrNB (Surgical Oncology), Consultant Surgical Oncologist, at Apollo Hospital International Ltd, Bhat, Gandhinagar.
The sentinel node is the first node the breast drains into. Testing it shows whether the armpit is involved, without removing every node.
Checking the armpit is part of nearly every breast cancer operation. This page explains how it is done and why fewer nodes come out now. The wider picture sits on the breast cancer surgery page.
Breast cancer, when it spreads, tends to reach the lymph nodes in the armpit first. Knowing whether it has done so changes what treatment follows. It guides chemotherapy, radiotherapy and the tablets taken afterwards.
For many years every woman had all the armpit nodes removed, to be sure. That answered the question but left a real price: a swollen arm, a stiff shoulder, numbness. Most of those women had clear nodes and gained nothing from the clearance.
A dye or tracer is injected into the breast. It travels to the first node. That node is removed and tested while you are still asleep.
The marker takes the same path a cancer cell would. The node that lights up is the sentinel node. Sometimes there are two or three. They are removed through a small cut in the armpit and sent to the pathologist.
If they are clear, nothing further is done to the armpit. If they carry disease, the next step is decided on how much disease is found, not on its presence alone.
| Sentinel node biopsy | Axillary dissection | |
|---|---|---|
| Nodes removed | Usually 1 to 3 | Usually 10 to 20 |
| Extra operating time | About 30 minutes | About 45 to 60 minutes |
| Drain needed | Usually not | Yes |
| Arm swelling risk | Low | Higher |
| Numb patch on inner arm | Uncommon | Common |
| Shoulder stiffness | Uncommon | More likely without exercises |
Either can be combined with breast conservation or with mastectomy. The armpit decision and the breast decision are separate decisions.
Shoulder exercises start the day after surgery. Using the arm normally, and treating cuts on that side promptly, both lower the swelling risk.
Move the shoulder through its full range every day from the start. A stiff shoulder is easier to prevent than to treat.
On the operated side, clean and cover any cut or burn early, and see someone if the arm becomes red, hot or suddenly larger. Blood pressure cuffs and blood tests are better taken from the other arm where there is a choice.
Swelling that does start can be treated. Say so early rather than waiting for the next scheduled visit.
It is the first lymph node the breast drains into. If cancer cells travel to the armpit, that node is where they arrive first. Testing it tells you about the rest.
A dye, a weak radioactive tracer, or both are injected into the breast before surgery. They travel the same path the cancer would. The node that takes up the marker is the one removed and tested.
The remaining armpit nodes are left alone. That is the whole point of the test. It spares most women a bigger operation and the arm problems that can follow it.
It does not always mean the rest must come out. With one or two involved nodes, radiotherapy to the armpit is often used instead. Where more are involved, a full clearance is the safer choice.
After sentinel node biopsy the risk is small, in the range of a few in a hundred. After a full armpit clearance it is higher. The exercises you are taught and care with cuts on that arm both lower it.
A patch of numbness on the inner upper arm is common after a full clearance, because a small sensory nerve runs through the area. It usually fades over months. Strength is not affected.
At Apollo Hospital International Ltd, Bhat, Gandhinagar. Consultations are held there as well. Call +91 63555 64601 to fix a time.
Send your scans and biopsy report ahead, then call to fix a time.
Dr Swapnil Sharma — MBBS, MS, FMAS, DrNB (Surgical Oncology)
Consultant Surgical Oncologist
Consultations and surgery: Apollo Hospital International Ltd, Bhat, Gandhinagar
Appointments: +91 63555 64601 · WhatsApp
Last updated: 24 September 2026. Reviewed by Dr Swapnil Sharma, MBBS, MS, FMAS, DrNB (Surgical Oncology), Consultant Surgical Oncologist.
This page is for information. It is not a substitute for an examination and a personal opinion.
