Clinical significance of minimal sentinel node involvement and management options

Since its introduction in the mid-1990s, sentinel lymph node (SLN) biopsy has revolutionized the management of breast cancer patients, allowing for a minimally invasive method to accurately stage the axilla without the need for axillary lymph node dissection and its concomitant morbidity in node-negative patients. The ability to identify the lymph nodes most likely to harbor metastases has allowed for increased scrutiny of these lymph nodes, often finding minimal disease in the SLNs. The relevance of such minute disease has been controversial, and there has been considerable debate as to how best to manage such patients.