A 55-year-old lady visits surgery OPD with a three month old history of a painless hard swelling in her left breast.
On examination, it is found that the swelling is firm, immovable and is located in upper inner quadrant, along with retraction of nipple.
She is advised to undergo pre-operative sentinel lymph node biopsy and surgery. Explain the anatomical basis of pre-operative sentinel node biopsy in this case.
The patient’s painless, hard, immovable breast swelling with nipple retraction suggests breast carcinoma. The basis for pre-operative sentinel lymph node biopsy (SLNB) is the predictable sequential lymphatic drainage of the breast. Lymph, especially from the upper inner quadrant, first drains to a specific sentinel node in the axilla or occasionally the internal mammary chain. If cancer spreads, it initially involves this node before other regional nodes. Biopsy of the sentinel node allows accurate cancer staging and guides management, potentially avoiding extensive axillary dissection if the node is negative, reducing surgical morbidity while ensuring oncological safety.
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