The evolving role of sentinel lymph node biopsy for breast cancer

Recent studies have demonstrated that the sentinal node biopsy (SNB), which utilizes a simple principle, is a reliable and minimally invasive method for determining the status of the regional lymph nodes in patients with clinically node-negative breast cancer. The technique has been widely used in the management of patients with early breast cancer despite the lack of long-term data from randomised controlled trials which are currently in progress. The present article reviews the role of the SNB in the context of axillary node sampling and determines the requirements for its safe clinical application. It also highlights the need for further research to clarify the role of the SNB in high risk DCIS, the value of preoperative lymphascintigraphy, and the clinical relevance of internal mammary node dissection and focused examination of the sentinal node by immunohistochemistry and polymerase chain reaction.