Abstract
The presence of tumor cells can be identified in the lymph node when metastasis has occurred from the primary cancer site into the lymph node (1) If the sentinel lymph node ganglion is negative for the presence of tumor cells at the time of histological examination, the other lymph nodes are also negative in 99% of cases. If no tumor cells are identified in the sentinel lymph node ganglion by histological examination, the other lymph nodes are also negative for the presence of tumor cells in 99% of cases. The sentinel lymph node advantageously replaces axillary dissection as a staging method in breast cancer T1 and T2 (2). Approximately 40% of breast cancers metastasize to axillary lymph nodes and metastatic extension depends on disease stage. Sentinel lymph nodes are affected in the following stages: T1a (4.3%), T1b (19.5%), T1c (23.8%), T2 (48.9%), T3 (66.7%).
Highlights
In recent years the management of breast cancer has changed considerably
The difficulty of the methods described demonstrates the necessity of having an experienced pathologist to evaluate extemporaneously micro metastases or isolated metastasis cells
As proposed by the American Society of Breast Surgeons, accreditation should be given to surgeons practicing sentinel node examination in breast cancer after teaching and evaluating their technique
Summary
In recent years the management of breast cancer has changed considerably. One such example of this is the disappearance of great axillary curage. The study of lymph nodes has a prognostic value and guides decision making for further treatment [3,4,5,6]. Examination of the sentinel lymph node has become the gold standard. Evidence of metastatic invasion of at least three lymph nodes is recommended. The examination of the sentinel node during surgery remains arbitrary as micro-metastases cannot be detected. The sensitivity of this technique is dependent on the sections obtained, and interpretation can be challenging for pathologists. Oftentimes, further examination in the laboratory is necessary to obtain and validate reliable results
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