10. Sentinel node biopsy in primary breast cancer

Sentinel node biopsy is a minimally invasive but accurate way of staging the axilla such that as many as 50% of women with primary breast cancer could avoid axillary clearance and the morbidity this carries with it. The methodology has yet to be perfected but identification of the sentinel node(s) with either dye or isotope, or with a combination of these, is a robust technique that is quick to learn and correctly predicts the status of the rest of the axilla in significantly more than 90% of patients. Improvements in the methodology and in patient selection will inevitably make sentinel node biopsy even more accurate. Studies to demonstrate the survival impact of replacing axillary clearance with sentinel node biopsy and selective axillary node treatment are required and are in their early stages.