Sentinel Lymph Node Dissection

• First applied to breast cancer patients in 1991
• first widespread use was for cutaneous melanoma
• SLN decreases axillary morbidity.  Lymphedema is 1%-3%.  Decreased risk of parethesias.
• The axillary recurrence rate was 0% with the negative sentinel lymph node group in one of the studies.
• Frozen section examinations of the lymph nodes in the OR has a false negative rate of 10-15%.

Axillary Lymph Node status in Breast Cancer

• Axillary lymph node status is the strongest prognostic indicator for breast cancer patients.
• Axillary lymph node status most likely doesn’t need identification with DCIS (Ductal Carcinoma In Situ) disease.  There is less than a 1% chance of a positive lymph node status in the axilla with DCIS.
• If there is a suspicion of an invasive component of breast cancer than consider sentinel lymph node procedure for diagnosing Axillary lymph node status.