Sentinel node biopsy in breast cancer.

Regional lymph node involvement is the most important prognostic indicator in most solid tumors. Lymph nodes first to receive the lymphatic flow from the peritumoral region are called sentinel nodes. Extirpation methodology of these nodes is rather short (around 10 years) and is related to the following names: Cabanas, Morton, Uren, Berman, Glass, Alex, Cragg.... There are two visualization methods of sentinel nodes: detecting dyes (isosulfan blue or patent-blau V) and radioactive detection (technetium-Tc-99m-antimony-sulfide, sulphur-colloid or human albumin). Scintigraphy is usually performed 24 hours prior to surgery, whereas staining immediately before operation. Extirpated nodes are histopathologically examined and then findings are compared with the findings of other axillary nodes which require obligatory dissection. Results of great studies (Veronesi, Paganelli) show that under precise criteria it would be possible to form a group of patients, prepared for breast cancer surgery, in whom axillary lymph dissection could be avoided.