MINIMALLY INVASIVE AXILLARY INTERVENTION IN BREAST CANCER SURGERY: SENTINEL LYMPH NODE BIOPSY

Abstract

Modern breast surgery has been evolving over the last century by changing to a less aggressive approach including the less invasive axillary procedures. Today, the major role of axillary surgery is limited to staging and prognostication. Sentinel lymph node (SLN) biopsy is a recently developed, minimally invasive approach for staging the regional nodal basin in the primary management of early-stage breast cancer. By definition, the SLN is the first node to receive direct lymphatic drainage from a primary tumor within the breast and the most likely to contain metastatic disease, if present, Since conventional axillary level I-II dissection results with significant morbidity and decreased guality of life, SLN biopsy has been performed to overcome this problem by obtaining accurate information reflecting axillary status. It has been suggested that this technique avoids the complications associated with more extensive axillary dissection. Many authors have confirmed the high efficacy of SLN in correctly predicting the disease status of the lymph node basins in patients with breast cancer. However, there remain controversial issues which require to be resolved before SLN biopsy becomes a widely accepted part of breast cancer care. More data are needed before defining the definitive role of SLN biopsy. In this article, the studies pertaining to SLN biopsy procedure were reviewed. The ongoing trials on the role of SLN biopsy in the management of clinically node negative patients are discussed. Altogether, this review covers the rationale, indications, complications, present controversies, validity and prospects of SLN biopsy.