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      Sentinel lymph nodes for breast carcinoma: an update on current practice.

      1 , 1

      Histopathology

      Wiley

      breast carcinoma, neoadjuvant chemotherapy, sentinel lymph node

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          Abstract

          Sentinel lymph node (SLN) biopsy has been established as the standard of care for axillary staging in patients with invasive breast carcinoma and clinically negative lymph nodes (cN0). Historically, all patients with a positive SLN underwent axillary lymph node dissection (ALND). The ACOSOG Z0011 trial showed that women with T1-T2 disease and cN0 who undergo breast-conserving surgery and whole-breast radiotherapy can safely avoid ALND. The main goal of SLN examination should be to detect all macrometastases (>2 mm). Gross sectioning of SLNs at 2-mm intervals and microscopic examination of one haematoxylin and eosin-stained section from each SLN block is the preferred method for pathological evaluation of SLNs. The role and timing of SLN biopsy for patients who have received neoadjuvant chemotherapy is controversial, and continues to be explored in clinical trials. SLN biopsies from patients with invasive breast carcinoma who have received neoadjuvant chemotherapy pose particular challenges for pathologists.

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          Author and article information

          Journal
          Histopathology
          Histopathology
          Wiley
          1365-2559
          0309-0167
          Jan 2016
          : 68
          : 1
          Affiliations
          [1 ] Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
          Article
          NIHMS797874
          10.1111/his.12853
          5027880
          26768036

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