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Biopsy Alternative Makes Node Removal Less Painful

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CARY, N.C. — For women who have breast cancer, doctors usually remove 10 to 20 lymph nodes from under the arm in order to find out if it as spread.

That procedure can cause numbness, loss of range of motion and painful swelling. Doctors at WakeMed are looking at a new procedure that could be a better alternative.

Dr. Sabah Hamad is one surgeon who performs this relatively new procedure called a sentinel lymph node biopsy.

During the procedure, Hamad injects a radioactive medicine into the breast tissue and then runs a Gamma probe over the armpit. She is signaled of a hot spot when the monitor shows high numbers and rings loudly.

"There's clearly a hot lymph node in there somewhere," Hamad said.

Then, she removes the sentinel lymph node and sends it to pathology for testing.

On average, surgeons remove one to four lymph nodes during this procedure.

"You can really pick up any small cancer that's in there," Hamad said.

She also said that fewer nodes means pathologists can be more thorough.

"Think of it as children. If you've got one or two kids you can do a lot more for them," she said. "If you've got 10 kids, it's a little less likely to check on everything. Some things are more likely to fall through the cracks."

Studies show that sentinel node biopsies detect 15 percent more cancers than traditional approaches.

Darla Wright said she likes those odds. The 35-year-old was diagnosed with breast cancer three months ago.

"You think, 'Me? It couldn't be,'" she said.

Last month, Wright had a sentinel node biopsy and Hamad removed two nodes. Fortunately, the cancer had not spread.

"It meant 'Oh glory.' It just meant happiness. I was overwhelmed," she said.

Wright still has to go through several weeks of chemotherapy and radiation. She said knowing the cancer is under control gives her peace of mind.

"You almost have enough strength to go on to the next mode to be prepared for the next step," she said.

Doctors said this procedure does not have numbness and other side effects.

Sentinel node biopsies are offered at major hospitals across the region.

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