Lymphatic mapping and sentinel lymph node biopsy for breast cancer: Developments and resolving controversies

Over the past decade, lymphatic mapping and SLN biopsy has been increasingly integrated into the diagnosis and treatment of early-stage breast cancer. Although some of the long-term results from pivotal, large prospective trials of SLN biopsy for breast cancer are not yet available, more than 1,500 articles have now been published on this subject. On the basis of these data, lymphatic mapping and SLN biopsy has become a standard surgical procedure both in the United States and other developed countries. Despite a clear picture of increasing integration of SLN biopsy into standard diagnostic and therapeutic strategies for breast cancer, several areas of controversy remain. One of the promising future directions with SLN biopsy could be its use as a bridge to the complete elimination of axillary dissection, despite the presence of nodal metastases. © 2005 by American Society of Clinical Oncology.