[Changes in the surgery and histopathology of sentinel lymph nodes for breast cancer at the Bács-Kiskun County Teaching Hospital (Kecskemét) - Experiences of nearly 30 years and 4000 operations.].

We introduced sentinel lymph node biopsy for breast cancer in 1997. Axillary lymphadenectomy was performed routinely at the beginning, then limited to sentinel node positive cases, macrometastatic cases and ultimately, to >2 nodes or post-neoadjuvant metastatic cases. From vital blue dye only labelling, (combined) radiocolloid, fluorescent and radar localisation labelling all received their place in the staging procedure. Histopathology also changed: 1. from extensive analysis identifying as many small metastases as possible to identifying/excluding macrometastatic involvement, 2. from routine to restricted use of immunohistochemistry, 3. from routine imprint cytology identifying as many macrometastases as possible to its selective use. The review describes these changes and also points to the rationale behind them. Along practical considerations, surgical and pathological techniques may undergo further changes in the future.