Significance and method of sentinel lymph node biopsy in breast cancer

Objective To discuss the method and clinical value of sentinel lymph node(SLN)biopsy in the management of breast cancer.Methods Technetium-99m labeled sulfur colloid was injected into the breast substance adjacent to the primary tumor or resection cavity,2-4 hours later,patients underwent intraoperative lymphatic mapping using a hand-held gamma detector,the SLN was identified and removed,followed by a definitive cancer operation,including a axillary lymph node dissection(ALND).The predictive value of SLN for the axillary tumor status was evaluated with histological and IHC examination.Results The SLN was identified in 97(89.8%)of patients using this method,altogether 180 SLNs were harvested,on average 1.9 SLNs were examined and 12.1ALNs were removed.SLN was 100% predictive of axillary lymph node status in the 97 patients.Conclusion Intraoperative lymphatic mapping using a hand-held gamma detector to identify SLN is technically possible and histologic characteristics of the SLN probably reflect the histologic characteristics of the rest of the axillary lymph nodes and SLN may become an indicator of SLNB substituting for ALND.