Sentinel lymph node biopsy
node-negative
BREAST CANCER
In the 1990's, which is rather recently considering the long history of surgery for breast cancer, the feasibility of the SLN procedure was shown. This built the foundation for a much less invasive and morbid, yet oncologically safe surgical staging concept for the axilla. Veronesi et al. included 516 patients, of which 259 received SLNB and ALND only if the SLN was positive, which did not show a difference in overall survival after a median of 46 months. The pathological positivity rate was 33.9%, with an accuracy of 96.9%, as tested in the ALND group. In 34.3% (60/175) the positive SLN showed only micrometastases (i.e., <2 mm), whereas all of these patients received ALND, which subsequently found no more positive nodes in 83.4%, and only one more positive LN in 16.7% [Therefore, in clinically node-negative patients the SLN procedure was deemed applicable, and in case of negative SLN did not show an impact on recurrence-free or overall survival.