Occult breast cancer management with axillary lymph node dissection versus sentinel lymph node biopsy: Case reports and literature review

Breast cancer is the most common cancer worldwide. In patients with occult breast cancer, sentinel lymph node biopsy (SLNB) has been shown to reduce complications, shorter hospital stay, and improved quality of life compared to axillary lymph node dissection (ALND). This study presents two case reports comparing outcomes of ALND versus SLNB in the management of occult breast cancer. CASE 1: A 52-year-old female presented with a left axillary tail mass which showed invasive ductal carcinoma. Underwent left axillary lymph node dissection. She developed postoperative drain seroma. The patient was managed conservatively. CASE 2: A 65-year-old female known case of diabetes mellitus type 2, hypertension, and dyslipidemia presented with a right axillary tail mass which showed features suggestive of metastatic carcinoma, most arising from breast origin. The patient underwent uneventful right sentinel lymph node biopsy without any postoperative complications. While ALND is associated with more complications including, seroma, lymphedema, paresthesia, infection, and nerve injury, SLNB offers a less invasive approach with favorable outcome. SLNB is an effective and less morbid approach for managing occult breast cancer and warrants further study in larger cohorts.