Axillary Sentinel Lymph Node Biopsy for Carcinoma of the Breast: A Personal Perspective

Because of its low rate of complications, once the technique is learned, axillary sentinel lymph node biopsy has all but replaced axillary dissection as the appropriate first step in the assessment of the axilla in patients with clinically node negative T1 and T2 breast cancer. The author's experience with the technique is presented with the criteria for successful identification and review of the sentinel node (SN). The author's choice for identification of the SN is blue dye rather than radiocolloid. Frozen section of the SN is recommended as highly accurate, with levels I and II dissection to be considered if the SN's contain metastasis. The finding of sub-microscopic metastasis by immunochemical techniques should not currently influence clinical decisions.