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International Journal of Breast Cancer
Volume 2011, Article ID 195892, 9 pages
http://dx.doi.org/10.4061/2011/195892
Review Article

Which Patients Need an Axillary Clearance after Sentinel Node Biopsy?

Research Oncology, Guy's Hospital, 3rd Floor Bermondsey Wing, London SE1 9RT, UK

Received 4 April 2011; Revised 16 June 2011; Accepted 2 July 2011

Academic Editor: Christoph Klein

Copyright © 2011 Anastasia Pazaiti and Ian S. Fentiman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sentinel lymph node biopsy (SLNB) is a safe and accurate minimally invasive method for detecting axillary lymph node (ALN) involvement in the clinically negative axilla thereby reducing morbidity in patients who avoid unnecessary axillary lymph node dissection (ALND). Although current guidelines recommend completion ALND when macro- and micrometastatic diseases are identified by SLNB, the benefit of this surgical intervention is under debate. Additionally, the management of the axilla in the presence of isolated tumour cells (ITCs) in SLNB is questioned. Particularly controversial is the prognostic significance of minimal SLNB metastasis in relation to local recurrence and overall survival. Preliminary results of the recently published Z0011 trial suggest similar outcomes after SNB or ALND when the SN is positive, but this finding has to be interpreted with caution.