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Sentinel Lymph Node Biopsy in Breast Cancer

Stefano MM Basso, MD, and Franco Lumachi, MD

Since the first radical mastectomy proposed by William S Halsted in the 1890s, axillary lymph node dissection (ALND) has been considered the standard procedure for surgical treatment of breast cancer [1]. Although the extent of surgery decreased, ALND was extensively performed for a century. ALN status is the most important prognostic factor for patients with breast cancer. However, although ALND is accurate in determining nodal status, this is at the expense of significant morbidity, both physical (pain, lymphedema, loss of strength) and psychological (worsening of body image) [2,3]. The concept of the “sentinel lymph node” (SLN) in breast cancer was introduced in the 1990s, following research on penile cancer and melanoma [4]. The objective was to perform less invasive surgery in a targeted population, given the risk of postoperative complications and discomfort experienced after ALND [5].

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