Sentinel lymph node (SLN) in breast cancer: prediction of axillary metastasis confined to the SLN spares patients further axillary dissection]

Although regional control of the axilla in patients with breast cancer is important, axillary lymph node dissection (ALND) is performed mainly for staging purposes. The sentinel lymph node (SLN) that first receives lymphatic drainage from the tumor was investigated. After SLN identification, ALND or radiation therapy is performed in patients with SLN metastasis who are also likely to have non-SLN metastasis. However, it is important to select patients with SLN metastasis who may benefit from further axillary treatment. The size of the primary tumor and the size of its SLN metastasis are reported to be associated with the presence of non-SLN metastases. Patients in whom the SLN indicates less than 20% of nodes are involved have a low probability of non-SLN involvement and therefore can avoid further axillary treatment. Although large clinical trials are necessary for confirmation, it appear, that patients with axillary involvement confined to the SLN can be spread further ALND.