Sentinel Node Biopsy in Breast Cancer. Technique and Indication – Standard of Care

Overview

Sentinel node biopsy proved to be a useful and accurate procedure for axillary staging in breast cancer. Combination of the current techniques with radiocolloids and blue dye, applicated superficial (intradermal, subdermal, peri- and subareolar) and deep (peritumoral, intratumoral, subtumoral) enable high indentification rates und negative predictive values. It should be performed by surgeons, pathologists and management teams of nuclear medicine with appropriate training and experience. Accepted indications are uni- and multifical tumor less than 3 cm without suspicious findings in the axilla, further in patients with large ductal carcinoma in situ and after preoperative chemotherapy. Sentinel node biopsy is still under discussion in patients with multicentric tumors and nodes outside of the axilla, although there are good results in applying this method, few data exist.

Sentinel node biopsy is a team approach, prerequisites are good cooperation and well defined stuctures of qualities and documentation. Participation in national clinical studies are recommended.

Key words:
breast cancer – sentinel node biopsy – indications – technique