Lymphatic mapping and retrieval of the sentinel lymph node in treatment of early breast cancer

Lymphatic mapping and sentinel lymph node biopsy is an important step to surgical individualization of breast cancer therapy. With lymphatic mapping and minimally invasive biopsy of one or two detected lymph nodes the method provides an exact evaluation of the nodal status. Using sentinel lymph node biopsy (SLNB), costs and morbidity of an axillary lymph node dissection (ALND) can be avoided in nodal negative patients, whereas nodal positive patients are chosen for ALND very selectively according to the detection of an increased percentage of micrometastases. While experienced centers are introducing this method into clinical practice for the benefit of patients with early-stage breast cancer in Europe, further research should focus on quality control, definition of standards considering the individual needs of the individual patient, and the evaluation of the impact of micrometastases. This article gives an overview of the current knowledge of SLNB and discusses critically current indications and methods as well as application techniques.