[Sentinel lymphnode: surgical standard in breast cancer]

Evaluation of the sentinel lymph node (SLN) is capable of avoiding dissection in a high percentage of node negative patients (> 90). It is essential that "useless" treatment not be performed as the negative collateral effects are not justifiable and furthermore present financial laws do not reimburse dissections carried out in the absence of node disease. The intraoperative evaluation of the SL is an extremely expensive procedure, due both to the personnel required and to the time necessary for the patient to remain in the operating room awaiting histology results. In fact, it is far easier to retrieve the SLN in day hospital and to examine the specimen on fixed material and not frozen. Twenty three cases of deferred SLN were evaluated, the results of which were highly reliable because of these, only 3 dissections were performed after an average of 4 days from biopsy. As SL evaluation does not increase the "curability" of the disease but only reduces any eventual complications, we believe it should be restricted to extremely selected and specialistic institutions due to the great economical and organizational cost involved.