Gynaecological cancers such as endometrial and cervical cancer often require careful evaluation of lymph nodes to determine whether the disease has spread. Traditionally, surgeons removed multiple pelvic lymph nodes to check for metastasis. While effective, this approach increased surgical complications and long-term side effects.

In recent years, sentinel lymph node biopsy (SLNB) has emerged as a safer, precision-based alternative that allows accurate cancer staging while minimizing surgical trauma.

Understanding the Role of Lymph Nodes in Cancer

Lymph nodes are part of the body’s immune system. In cancer, they serve as one of the first locations where malignant cells may spread.

Cancer spread typically follows a predictable pattern. The first lymph node that receives drainage from a tumor is called the sentinel lymph node. If this node is free of cancer, it is unlikely that other nodes are involved.

This concept forms the foundation of sentinel lymph node biopsy.

What Is Sentinel Lymph Node Biopsy?

Sentinel lymph node biopsy is a surgical technique used to identify and remove the first draining lymph node from the tumor site.

The procedure generally involves:

• Injecting a special dye or tracer near the tumor

• Identifying the first lymph node that absorbs the tracer

• Surgically removing that node

• Sending it for detailed pathological analysis

This targeted method reduces the need for extensive lymph node removal.

Why Is Sentinel Lymph Node Biopsy Important in Gynaecological Cancer?

In cancers such as early-stage endometrial and cervical cancer, lymph node status plays a crucial role in determining further treatment.

However, complete pelvic lymph node dissection can lead to complications such as:

• Chronic leg swelling (lymphedema)

• Nerve injury

• Increased blood loss

• Longer recovery time

Sentinel lymph node biopsy helps reduce these risks while maintaining oncologic accuracy.

Clinical Benefits of Sentinel Lymph Node Biopsy

Modern oncology favors techniques that balance effectiveness with patient safety. Sentinel lymph node biopsy offers several advantages:

• Accurate detection of microscopic spread

• Lower risk of postoperative complications

• Shorter hospital stay

• Faster recovery

• Reduced risk of long-term lymphedema

This makes it particularly valuable in early-stage disease.

Which Patients Are Suitable Candidates?

Sentinel lymph node biopsy is generally recommended for:

• Early-stage endometrial cancer

• Early cervical cancer without obvious lymph node enlargement

• Selected vulvar cancers

Advanced-stage cancers may still require comprehensive lymph node removal depending on disease spread.

Safety and Effectiveness

Numerous studies have shown that sentinel lymph node biopsy provides reliable staging information when performed by experienced gynaecologic oncologists.

The accuracy of the procedure depends on:

• Proper surgical technique

• Use of appropriate tracers

• Pathological expertise

• Careful patient selection

When done correctly, it significantly reduces unnecessary surgical burden.

A Shift Toward Precision Oncology

Sentinel lymph node biopsy represents a broader shift in cancer treatment toward precision-based surgery. Instead of removing multiple lymph nodes “just in case,” surgeons now use targeted methods to gather the same critical information with fewer complications.

This evolution reflects the growing focus on improving both survival and quality of life for cancer patients.

Final Thoughts

Sentinel lymph node biopsy is a major advancement in gynaecological oncology. By accurately identifying whether cancer has spread while minimizing surgical trauma, it offers a balanced approach to cancer staging.

For selected early-stage cancers, this technique allows precise treatment planning, safer surgery, and improved recovery outcomes.