Lymphatic mapping in breast cancer

Carcinoma of the breast is the most common cancer among women, excluding skin cancer, and is the second leading cause of cancer-related deaths in women. The American Cancer Society estimates that in 1998 approximately 178,700 new cases of invasive breast cancer will be diagnosed and 43,500 deaths from breast canter will occur in women.(4) With the aging of the "baby boomer" population, the incidence of the disease will increase. The decrease in the mortality rate of breast The most accurate predictor of survival in breast cancer is the presence or absence of lymph node metastases. Lymphatic mapping with sentinel node biopsy is a new technique that provides more accurate nodal staging compared with routine histology for women with breast cancer, but without the morbidity of a complete lymph node dissection. Sentinel lymph node (SLN) biopsy is a more conservative approach to the axilla that requires close collaboration from the surgical team, nuclear medicine, and pathology. National trials are investigating the clinical relevance of the upstaging that occurs with a more intense examination of the SLN. As is the case with breast preservation as a viable alternative to mastectomy for the definitive treatment of the primary node, selective lymphadenectomy has the ability to decrease morbidity without compromising patient care.