Medical Oncologist
CION Cancer Clinics
Sentinel node biopsy for vulval cancer | CION Cancer Clinics
A sentinel node biopsy for vulvar cancer removes only the first lymph node, or the first few, that the cancer drains to in the groin. If that node is clear, the other groin nodes can usually stay, which means far less leg swelling and fewer wound problems than a full clearance. It suits women with a small, single cancer and normal-feeling nodes. This page explains how it is done and what happens after the result. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a sentinel node biopsy for vulval cancer?
- What happens, from the injection to the result?
- Who is it suitable for, and who is it not?
- Sentinel node biopsy and full groin dissection, compared
- What happens if the sentinel node contains cancer?
- Four things families tell us, and what is actually true
- Words you will see, in plain language
- Common questions about sentinel node biopsy for vulval cancer
The short answer
What is a sentinel node biopsy for vulval cancer?
A sentinel node biopsy finds and removes only the first lymph node, or the first few, that fluid from the cancer drains to in the groin. If those nodes are free of cancer, the rest of the groin nodes can usually be left alone. It replaces a full groin clearance for many women with a small vulval cancer.
Why it matters to you
Removing all the groin nodes causes leg swelling and wound problems in a good share of women. A sentinel node biopsy is a much smaller operation in the groin, so these effects are far less common. When the cancer is small and the nodes feel normal, it finds spread reliably enough to be the standard approach in many national guidelines.
What it depends on
The method only works well in experienced hands, and when the tracer finds the node clearly. If no sentinel node shows up on one side during the operation, the surgeon usually removes all the nodes on that side instead. Your consent form will usually cover this possibility, so ask about it beforehand.
How it is done
What happens, from the injection to the result?
The tracer injection
Before the operation, usually the day before or that morning, a small amount of a mildly radioactive liquid is injected into the skin around the cancer. It stings briefly. The liquid travels the same path that cancer cells would take.
The scan
You lie under a camera that shows where the tracer has collected in the groin. The spot is marked on your skin. This scan does not show cancer; it shows the path.
In theatre
Once you are asleep, a blue dye is sometimes injected as well. The surgeon uses a hand-held probe that detects the tracer, and looks for a blue node, through a small cut in the groin crease. The sentinel node is removed along with the vulval operation.
The laboratory
The node is sliced thinly and examined in detail, which takes longer than an ordinary node. The result comes with the rest of the pathology report and decides whether anything more is needed in that groin.
Not sure whether this applies to you?
Ask an oncologistSuitability
Who is it suitable for, and who is it not?
These are the usual rules. Your team applies them to your biopsy, examination and scan.
Usually suitable
Women with a single vulval cancer that is not large, has grown more than a thin surface layer into the skin, and whose groin nodes feel and look normal on examination and scan.
Your team will check
- The size of the cancer
- The depth on the biopsy
- An ultrasound or scan of the groins
Usually not suitable
Women with a large cancer, more than one separate cancer, or groin nodes that already feel enlarged or look suspicious on a scan. In these situations a full groin dissection, or radiotherapy, is usually advised.
Also usually excluded
- Earlier surgery or radiotherapy to the groin
- A cancer that has come back
Not needed at all
Pre-cancer (VIN), and cancers that have grown only a very short distance into the skin, have such a small chance of reaching the groin that the nodes are usually not checked in any way.
Side by side
Sentinel node biopsy and full groin dissection, compared
Sentinel node biopsy
Full groin dissection
Removes one or a few nodes through a small cut
Removes the whole group of nodes and surrounding fat
Needs a tracer injection and scan beforehand
No tracer needed
Leg swelling and wound breakdown are much less common
Leg swelling and wound breakdown are common enough to plan for
Suits small, single cancers with normal nodes
Suits larger cancers or nodes that already look involved
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The result
What happens if the sentinel node contains cancer?
If the sentinel node is clear, nothing more is usually done in that groin, and you are followed up with regular checks. If it contains cancer, that groin needs further treatment, because other nodes nearby may also be involved.
The two usual next steps
For a very small deposit of cancer in the node, radiotherapy to the groin is often advised. For a larger deposit, a second operation to remove the remaining nodes is usually recommended, sometimes followed by radiotherapy. Your team decides on the size of the deposit, your recovery and your wishes.
The limit of the test
No test finds every cancer. Occasionally cancer is present in another node even when the sentinel node was clear. This is uncommon when the selection rules are followed, and it is why regular groin checks continue in the years after surgery. Tell your team about any new lump in the groin rather than waiting for the next appointment.
This page cannot tell you what your own result will be, or what it means for the future. Only your pathology report and your team can.Commonly believed
Four things families tell us, and what is actually true
"The radioactive injection will harm her or the family."
The amount is very small and fades quickly. It is less than many ordinary scans. There is no need to stay away from family at home, though the team may suggest keeping small children off your lap for the rest of that day.
"Checking only one node is cutting corners."
For the right woman it is the recommended approach, and it was adopted after large studies showed it finds groin spread reliably while sparing most women the effects of a full clearance. It is not a cheaper or quicker shortcut.
"Blue urine means something has gone wrong."
If blue dye was used, urine can turn blue or green for a day or so and the skin near the injection can look blue for longer. This is expected and harmless. A skin rash or breathing trouble after the dye is rare and needs telling the team at once.
"If the node is clear, she will not need any more check-ups."
Follow-up still matters. The groins and the vulva are examined regularly for several years, because a new growth or a lump in the groin is easier to treat when it is found early.
On your report
Words you will see, in plain language
- Sentinel node
- The first lymph node that fluid from the cancer drains to.
- Lymphoscintigraphy
- The scan after the tracer injection that shows where the sentinel node sits.
- Ultrastaging
- Cutting the node into very thin slices and using special stains, so that tiny amounts of cancer are not missed.
- Micrometastasis
- A very small deposit of cancer inside a node, found only on close examination.
- Isolated tumour cells
- A few scattered cancer cells in the node, smaller than a micrometastasis. Your team will explain what it means for your plan.
- Unifocal
- A single cancer, rather than more than one separate area.
Questions we are asked
Common questions about sentinel node biopsy for vulval cancer
Does the tracer injection hurt?
It stings for a short while, because it goes into sensitive skin near the cancer. Some centres use a numbing cream or spray first. The discomfort passes quickly, and the scan afterwards does not hurt at all. Tell the team if you are anxious and they will take it slowly.
What if no sentinel node is found?
Sometimes the tracer does not show a clear node on one side. When that happens, the surgeon usually removes all the nodes on that side in the same operation, so the groin is still checked. Ask before you sign whether this could apply, so that it is not a surprise when you wake.
Will I need a drain after a sentinel node biopsy?
Usually not in the groin, because so little tissue is removed. Some fluid can still collect under the cut and form a soft swelling, which usually settles on its own. A drain is more likely if the surgeon had to remove all the nodes on a side.
Can I still get leg swelling?
Yes, but it is much less common than after a full groin clearance. Radiotherapy to the groin afterwards raises the chance again. Look after the skin of your legs and tell the team early if a leg feels heavy, tight or swollen.
How long does the result take?
Longer than an ordinary node, because the node is examined in very thin slices. It usually arrives with the rest of the pathology report. If the wait feels long, call the helpline and we will find out where things stand.
Can it be done if I am diabetic or older?
Yes. Age and diabetes do not rule it out. In fact, the smaller groin operation can be especially helpful when wound healing is likely to be slower. What matters is whether the cancer meets the selection rules, and whether you are fit for the vulval operation itself.
Should I ask whether my centre offers it?
Yes. It needs a nuclear medicine service, a probe in theatre and a surgeon experienced in the method. Ask your centre whether they do it, how often, and what happens if the node cannot be found. Those are reasonable questions to ask any team.
Is it covered by Aarogyasri or insurance?
Usually yes, as part of approved cancer surgery. The tracer and scan may be listed separately on a bill. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card details and we will check your cover.
Meet the Specialists
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- Cancer Research UK — Surgery for vulval cancer
- National Cancer Institute — Vulvar Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Surgery for vulvar cancer
- National Cancer Institute — Sentinel Lymph Node Biopsy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Groin Node Surgery With VulvectomyThe full clearance, and when it is still neededLeg Lymphoedema After Vulvar Cancer SurgerySigns of leg swelling and what helpsWide Local Excision vs Partial vs Radical VulvectomyThe vulval operation done alongside itFollow-Up After Vulvar Cancer SurgeryWhy groin checks continue after a clear node
Talk to us
Wondering whether a sentinel node biopsy suits you?
Send us the biopsy report and any groin scan, or call the helpline. A surgical oncologist will go through the selection rules with you. One helpline serves every CION centre.