Sentinel lymphatic mapping in breast cancer

Axillary lymph node dissection remains an essential element in the surgical management of most patients with operable invasive breast cancer. The histologic status of the axillary nodes remains the single best predictor of survival in patients with breast cancer. Axillary lymph node dissection provides excellent regional tumor control, and the pathologic information gained is pivotal to the planning of adjuvant therapy. No procedure, invasive or noninvasive, has proved as accurate and effective in accomplishing these goals. Even so, axillary lymph node dissection is a major operation that may be associated with scarring, numbness, and occasionally lymphedema. With earlier mammographic detection, an increasing proportion of breast cancer patients will have negative axillary nodes, and this group presumably cannot benefit from axillary lymph node dissection. Sentinel lymphatic mapping may prove beneficial for this subset of breast cancer patients.