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British Medical Bulletin Advance Access published online on January 3, 2008
British Medical Bulletin, doi:10.1093/bmb/ldm032
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Detection of the sentinel lymph node in breast cancer

Santosh K. Somasundaram, Dennis W. Chicken and Mohammed R. S. Keshtgar*

Department of Surgery, Royal Free and University College Medical School, University College London, London, UK

* Correspondence to: Mohammed R. S. Keshtgar, Department of Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, UK. E-mail: m.keshtgar{at}ucl.ac.uk

Introduction: Introduction: Axillary lymph node status for lymphatic staging in breast cancer is the best prognostic indicator and guides systemic treatment. Sentinel lymph node (SLN) biopsy is a novel, minimally invasive technique for lymphatic staging proven to improve quality of life. The accurate detection of the SLN is paramount for the success of the procedure.

Methods: Relevant literature was reviewed with regards to the different dyes and techniques used for the detection of SLN in breast cancer.

Results: Highest identification rates and lowest false negative rates are achieved by using the combined blue dye and radiocolloid technique with pre-operative imaging using a gamma camera. There is a well-recognized learning curve to successfully perform SLN biopsy.

Conclusions: The concept of SLN has been well validated and is the standard of care in early breast cancer. A multidisciplinary approach and structured training is the key to the successful introduction of the technique.

Keywords: sentinel lymph node • breast cancer • sentinel node imaging • NEW START


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