ABSTRACT
In patients with breast cancer, optimal management of the axilla is often controversial and certainly evolving. Despite a few modifications in the intervening decades, axillary lymph node dissection (ALND) remained the standard of care for all breast cancer patients until Giuliano and Morton translated the sentinel lymph node biopsy (SLNB) model from melanoma to breast cancer in 1994. Several trials have compared the surgical SLNB with ALND and looked at long-term outcomes, such as overall survival, local recurrence and loco-regional recurrence. The exact techniques used to identify SLNs intraoperatively were varied, and some groups used an injection of radioisotope without blue dye or did not specify the use of the mono or dual tracer technique. Factors that may improve the success rate of repeat SLNB include injecting a larger amount of tracer and avoiding sub-areolar injection. It is also possible to repeat SLNB after a mastectomy with successful mapping occurring in most (83%) patients.
