Sentinel node biopsy in breast cancer

In breast cancer, sentinel node biopsy (SNB) has replaced diagnostic axillary clearance (AC) in nodal staging in numerous breast surgery units all over the world. However, there is no international standard in imaging, harvesting, and histological examination of the sentinel nodes. SNB has been validated in nodal staging of small, unifocal, clinically axillary-node-negative tumors, with a false-negative rate of approximately 5% of all axillary-node-positive cases. Despite the false-negative results, the method is assumed to provide accurate nodal staging, revealing metastases that remain undetected in AC. Furthermore, clinically overt axillary metastases have been rare when omitting AC relying on tumor-negative sentinel node findings, at least during a short follow-up. SNB is associated with faster recovery and less long-term morbidity than AC. Although the results of the large randomized trials have still to come, SNB has become the standard of care in early breast cancer.