When is sentinel node biopsy unsuitable?
Sentinel node biopsy is not generally used in the following situations: • If the lymph nodes are enlarged on clinical examination. • If there is evidence for metastases at other body sites. • If the patient has previous undergone wide excision of the primary cancer, especially if a flap or graft closure has been used. This is because the lymphatic drainage may have been altered making the procedure inaccurate. • It may be difficult or impossible to perform a sentinel node biopsy when the primary cancer is on the head or neck as there are several lymph node clusters close together. It is particularly difficult if the cancer overlies the parotid gland in front of the ear. • A radioactive tracer should not be used during pregnancy (blue dye may be acceptable). • Blue dye should not be used if there is a history of allergy to it.
