[Controversial issues surrounding sentinel lymph node biopsy in breast cancer].

UNLABELLED

This article discusses controversies regarding sentinel lymph node (SLN) biopsy and offers the following

CONCLUSION

1. Combination of radioisotopes and blue dye, and of peritumoral and subdermal injections, may enhance the success rates of SLN identification. 2. Preoperative lymphoscintigraphy is the most useful for detecting an internal mammary SLN. However, the practicability of internal mammary SLN biopsy remains in the investigative stage. 3. Intraoperative diagnosis of SLN is necessary because patients with SLN metastases may be treated immediately with axillary lymph node dissection (ALND), but both frozen sections and imprint cytology have limitations for detecting micrometastases. 4. SLN micrometastases (0.2-2.0 mm) may be of prognostic importance and these can be histologically diagnosed on permanent sections of 200 microns intervals. 5. SLN biopsy may be indicated for patients with large or high-risk DCIS. 6. The accuracy of SLN biopsy after preoperative chemotherapy is still considered unproven.