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Sentinel Lymph Node

Anatomy and Physiology · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

First lymph node to receive drainage from the primary tumor.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (778 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

First lymph node to receive drainage from the primary tumor. sentinel lymph node biopsy is performed to determine early metastasis status because cancer cells may appear first in the sentinel node.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Lymph Node, Sentinel; Lymph Nodes, Sentinel; Sentinel Lymph Nodes; Sentinal Node; Node, Sentinal; Nodes, Sentinal; Sentinal Nodes.

Where it fits in the MeSH classification

Broader topics
Lymph Nodes
See also
Lymphatic Metastasis; Sentinel Lymph Node Biopsy

Related concepts

  • Sentinel Lymph Node Biopsy
  • Metastasis

Research landscape

PubMed indexes 2,943 records tagged with the MeSH heading “Sentinel Lymph Node” (counts retrieved 2026-10-31). 1,901 of them (64.6%) were published from 2020 onward, and the busiest period so far is 2020 onward with 1,901 records.

Reviews account for 393 records (13.4%) and meta-analyses for 103. Randomized controlled trials number 83 (2.8%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 0 records; 2000-2009: 1 records; 2010-2019: 1,112 records; 2020 onward: 1,901 records0through 199912000-20091,1122010-20191,9012020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19990
2000-20091
2010-20191,112
2020 onward1,901
Share of records by publication typeReviews: 13.4 percent; Meta-analyses: 3.5 percent; Randomized controlled trials: 2.8 percentReviews13.4% (393)Meta-analyses3.5% (103)Randomized controlled trials2.8% (83)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 2,943 PubMed records
TypeRecordsShare
Reviews39313.4%
Meta-analyses1033.5%
Randomized controlled trials832.8%

Method: PubMed query "Sentinel Lymph Node"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in anatomy and physiology

Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Elective nodal irradiation mitigates local and systemic immunity generated by combination radiation and immunotherapy in head and neck tumors
Darragh LB, Gadwa J, Pham TT, Van Court B, Neupert B, Olimpo NA, et al.
2022Research article
Design not recorded in structured metadata
217cc by
PMID 36385142 · DOI · PMC9668826
Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis
Che Bakri NA, Kwasnicki RM, Khan N, Ghandour O, Lee A, Grant Y, et al.
2023Meta-analysis
Design not recorded in structured metadata
110cc by
PMID 35946806 · DOI · PMC9994843
Reprogramming of sentinel lymph node microenvironment during tumor metastasis
Li YL, Hung WC
2022Review article
Design not recorded in structured metadata
63cc by
PMID 36266717 · DOI · PMC9583492
TROP2-targeted NIR-II fluorescence imaging for visualizing surgical margins and metastatic sentinel lymph nodes in breast cancers
Lou KL, Bai JW, Liu HT, Lin LL, Li CX, Gao YY, et al.
2026Research article
Design not recorded in structured metadata
3cc by
PMID 41712645 · DOI · PMC12933058

Elective nodal irradiation mitigates local and systemic immunity generated by combination radiation and immunotherapy in head and neck tumors [1]

Research article Darragh LB, Gadwa J, Pham TT, Van Court B, Neupert B, Olimpo NA, et al. · · 2022 · cited 217 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
In the setting of conventional radiation therapy, even when combined with immunotherapy, head and neck cancer often recurs locally and regionally.
Closing excerpt
Our data support using lymphatic sparing radiation therapy for head and neck cancer.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (152 words)

In the setting of conventional radiation therapy, even when combined with immunotherapy, head and neck cancer often recurs locally and regionally. Elective nodal irradiation (ENI) is commonly employed to decrease regional recurrence. Given our developing understanding that immune cells are radio-sensitive, and that T cell priming occurs in the draining lymph nodes (DLNs), we hypothesize that radiation therapy directed at the primary tumor only will increase the effectiveness of immunotherapies. We find that ENI increases local, distant, and metastatic tumor growth. Multi-compartmental analysis of the primary/distant tumor, the DLNs, and the blood shows that ENI decreases the immune response systemically. Additionally, we find that ENI decreases antigen-specific T cells and epitope spreading. Treating the primary tumor with radiation and immunotherapy, however, fails to reduce regional recurrence, but this is reversed by either concurrent sentinel lymph node resection or irradiation. Our data support using lymphatic sparing radiation therapy for head and neck cancer.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36385142 · DOI · PMC9668826

Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis [2]

Meta-analysis Che Bakri NA, Kwasnicki RM, Khan N, Ghandour O, Lee A, Grant Y, et al. · · 2023 · cited 110 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
ObjectiveTo evaluate the impact of axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) on upper limb (UL) morbidity in breast cancer patients.
Closing excerpt
The findings support the continued drive to de-escalate axillary surgery.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (191 words)

ObjectiveTo evaluate the impact of axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) on upper limb (UL) morbidity in breast cancer patients.BackgroundAxillary de-escalation is motivated by a desire to reduce harm of ALND. Understanding the impact of axillary surgery and disparities in operative procedures on postoperative arm morbidity would better direct resources to the point of need and cement the need for de-escalation strategies.MethodsEmbase, MEDLINE, CINAHL, and PsychINFO were searched from 1990 until March 2020. Included studies were randomized-controlled and observational studies focusing on UL morbidities, in breast surgery patients. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The prevalence of UL morbidity comparing SLNB and ALND at ResultsSixty-seven studies were included. All studies reported a higher rate of lymphedema and pain after ALND compared with SLNB. The difference in lymphedema and pain prevalence between SLNB and ALND was 13.7% (95% confidence interval: 10.5-16.8, P ConclusionsPrevalence of lymphedema after ALND was higher than previously estimated. ALND patients experienced greater rates of lymphedema, pain, reduced strength, and range of motion compared with SLNB. The findings support the continued drive to de-escalate axillary surgery.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 35946806 · DOI · PMC9994843

Reprogramming of sentinel lymph node microenvironment during tumor metastasis [3]

Review article Li YL, Hung WC · · 2022 · cited 63 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Metastasis is a major cause of death in patients with cancer.
Closing excerpt
In this review article, we summarize recent findings on the reprogramming of SLN during lymphatic invasion and discuss the possibility of inhibiting tumor metastasis and eliciting anti-tumor immunity by targeting SLN.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (276 words)

Metastasis is a major cause of death in patients with cancer. The two main routes for cancer cell dissemination are the blood and lymphatic systems. The underlying mechanism of hematogenous metastasis has been well characterized in the past few decades. However, our understanding of the molecular basis of lymphatic metastasis remains at a premature stage. Conceptually, cancer cells invade into lymphatic capillary, passively move to collecting lymphatic vessels, migrate into sentinel lymph node (SLN;, the first lymph node to which cancer cells spread from the primary tumor), and enter the blood circulatory system via the subclavian vein. Before arriving, cancer cells release specific soluble factors to modulate the microenvironment in SLN to establish a beachhead for successful colonization. After colonization, cancer cells inhibit anti-tumor immunity by inducing the recruitment of regulatory T cell and myeloid-derived suppressor cells, suppressing the function of dendritic cell and CD8+ T cell, and promoting the release of immunosuppressive cytokines. The development of novel strategies to reverse cancer cell-triggered SLN remodeling may re-activate immunity to reduce beachhead buildup and distant metastasis. In addition to being a microanatomic location for metastasis, the SLN is also an important site for immune modulation. Nanotechnology-based approaches to deliver lymph node-tropic antibodies or drug-conjugated nanoparticles to kill cancer cells on site are a new direction for cancer treatment. Conversely, the induction of stronger immunity by promoting antigen presentation in lymph nodes provides an alternate way to enhance the efficacy of immune checkpoint therapy and cancer vaccine. In this review article, we summarize recent findings on the reprogramming of SLN during lymphatic invasion and discuss the possibility of inhibiting tumor metastasis and eliciting anti-tumor immunity by targeting SLN.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36266717 · DOI · PMC9583492

TROP2-targeted NIR-II fluorescence imaging for visualizing surgical margins and metastatic sentinel lymph nodes in breast cancers [4]

Research article Lou KL, Bai JW, Liu HT, Lin LL, Li CX, Gao YY, et al. · · 2026 · cited 3 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
In early breast cancer surgery (EBC), free margins significantly decrease local recurrence in breast-conserving surgery (BCS), while metastatic status of sentinel lymph node (SLN) impacts axillary management.
Closing excerpt
Thus, this TROP2-targeting probe demonstrates its significance for fluorescence imaging-guided surgery with dual applicability in EBC, providing translational potential for further clinical decision-making.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (159 words)

In early breast cancer surgery (EBC), free margins significantly decrease local recurrence in breast-conserving surgery (BCS), while metastatic status of sentinel lymph node (SLN) impacts axillary management. However, intraoperative visualization of margins and metastatic SLNs (mSLNs) remains challenging. Here, we report a second-window near-infrared (NIR-II) fluorescence probe by conjugating ICG to TROP2-targeting cyclic peptide (TTP-ICG). Our results showed that TTP-ICG specifically binds to TROP2-expressing cells in vitro and identifies TROP2-positive tumors in vivo. In addition, TTP-ICG enabled efficient intraoperative evaluation of surgical margins and visualization of mSLNs at a submillimeter level in preclinical models. Additionally, we optimized the rapid incubation imaging method (RIIM) by shortening the procedure to less than 8 min, illustrating TTP-ICG's high performance in distinguishing malignant from normal tissues/fibroadenoma lesions as well as detecting metastatic lymph nodes in a cohort of 59 patients. Thus, this TROP2-targeting probe demonstrates its significance for fluorescence imaging-guided surgery with dual applicability in EBC, providing translational potential for further clinical decision-making.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41712645 · DOI · PMC12933058

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Axillary Nodal Evaluation in Breast Cancer: State of the Art [5]
    Chang JM, Leung JWT, Moy L, Ha SM, Moon WK · Radiology · 2020 · cited 301 times (Europe PMC)
  • Research article Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations [6]
    Holloway RW, Abu-Rustum NR, Backes FJ, Boggess JF, Gotlieb WH, Jeffrey Lowery W, et al. · Gynecol Oncol · 2017 · cited 282 times (Europe PMC)
  • Research article Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis [7]
    Bodurtha Smith AJ, Fader AN, Tanner EJ · Am J Obstet Gynecol · 2017 · cited 222 times (Europe PMC)
  • Research article Sentinel Node Mapping in Cervical and Endometrial Cancer: Indocyanine Green Versus Other Conventional Dyes-A Meta-Analysis [8]
    Ruscito I, Gasparri ML, Braicu EI, Bellati F, Raio L, Sehouli J, et al. · Ann Surg Oncol · 2016 · cited 124 times (Europe PMC)
  • Research article Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis [9]
    Bogani G, Murgia F, Ditto A, Raspagliesi F · Gynecol Oncol · 2019 · cited 112 times (Europe PMC)
  • Research article Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis [10]
    Nottegar A, Veronese N, Senthil M, Roumen RM, Stubbs B, Choi AH, et al. · Eur J Surg Oncol · 2016 · cited 98 times (Europe PMC)

References

  1. Darragh LB, Gadwa J, Pham TT, Van Court B, Neupert B, Olimpo NA, et al.. Elective nodal irradiation mitigates local and systemic immunity generated by combination radiation and immunotherapy in head and neck tumors. . 2022. PMID 36385142 · DOI · PMC9668826
  2. Che Bakri NA, Kwasnicki RM, Khan N, Ghandour O, Lee A, Grant Y, et al.. Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis. . 2023. PMID 35946806 · DOI · PMC9994843
  3. Li YL, Hung WC. Reprogramming of sentinel lymph node microenvironment during tumor metastasis. . 2022. PMID 36266717 · DOI · PMC9583492
  4. Lou KL, Bai JW, Liu HT, Lin LL, Li CX, Gao YY, et al.. TROP2-targeted NIR-II fluorescence imaging for visualizing surgical margins and metastatic sentinel lymph nodes in breast cancers. . 2026. PMID 41712645 · DOI · PMC12933058
  5. Chang JM, Leung JWT, Moy L, Ha SM, Moon WK. Axillary Nodal Evaluation in Breast Cancer: State of the Art. Radiology. 2020. PMID 32315268 · DOI
  6. Holloway RW, Abu-Rustum NR, Backes FJ, Boggess JF, Gotlieb WH, Jeffrey Lowery W, et al.. Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations. Gynecol Oncol. 2017. PMID 28566221 · DOI · PMC6075736
  7. Bodurtha Smith AJ, Fader AN, Tanner EJ. Sentinel lymph node assessment in endometrial cancer: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017. PMID 27871836 · DOI
  8. Ruscito I, Gasparri ML, Braicu EI, Bellati F, Raio L, Sehouli J, et al.. Sentinel Node Mapping in Cervical and Endometrial Cancer: Indocyanine Green Versus Other Conventional Dyes-A Meta-Analysis. Ann Surg Oncol. 2016. PMID 27160526 · DOI
  9. Bogani G, Murgia F, Ditto A, Raspagliesi F. Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2019. PMID 30952370 · DOI
  10. Nottegar A, Veronese N, Senthil M, Roumen RM, Stubbs B, Choi AH, et al.. Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis. Eur J Surg Oncol. 2016. PMID 27005805 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

2,943
PubMed records on this heading
65%
published since 2020
393
review articles
83
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

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