Onkologie. 2011:5(1):16-22

Sentinel lymph node biopsy in women with early breast cancer

Václav Pecha, Dušan Kolařík, Erika Menzlová, Monika Dvorská, Markéta Trnková

Mamma centrum MEDICON, Praha

Breast cancer is the most common malignant disease in women accounting for 23 % of all female malignancies. In 2007, its incidence in

the Czech Republic exceeded 120 cases per 100,000 women, placing the country among those with the highest detection rates for this

condition. Despite an ever-increasing incidence, the mortality rates for breast cancer show a stable or even slightly decreasing trend

because of the availability of modern diagnostic and therapeutic modalities (1).

Total mastectomy and complete axillary lymph node dissection was a traditional therapeutic approach throughout the twentieth century.

This therapeutic strategy was derived from Halsted‘s belief that breast cancer was a localized disease which could be managed with

radical (or super-radical) locoregional therapy (2, 3).

At present, there is no doubt about the primary systemic nature of breast malignancies and the approach to treatment of this condition

has changed substantially. There is a clear trend towards less radical surgery. Ablations have been largely replaced by breast-conserving

procedures, usually followed by adjuvant radiotherapy; the proportion of these partial procedures is further increasing due to the use of neoadjuvant

therapy. Currently, sentinel lymph node biopsy (SLNB) is a widely accepted standard for early breast cancer in axillary surgery.

Sentinel lymph node is defined as the first lymph node (or group of lymph nodes) to receive lymphatic drainage from a primary tumour, thus

representing the first site of lymphatic spread of the tumour. The status of the axillary lymph nodes is the most important single prognostic

factor for the overall survival rate of patients with breast cancer (4, 5). It has been repeatedly shown that sentinel lymph node biopsy is a

very sensitive and accurate method to evaluate the lymph node status in women with early breast cancer (6, 7). In women with a negative

finding in the sentinel lymph node, no further surgical intervention in the axilla is indicated according to the NSABP B-32 study (6).

Keywords: breast cancer, sentinel lymph node (SLN), sentinel lymph node biopsy (SLNB), lymphatic mapping

Published: February 25, 2011  Show citation