Abstract

Sentinel lymph node (SLN) has been described as the first Iymph node to which the tumor drains. The basis of SLN biopsy depends on the idea that, "the first Iymph node to which the tumor drains is the first metastatic site". This procedure, which was orginally performed for malignant melanoma, and later on trained for other tumors, had the potential to find the area of application mostiy on breast cancer. The purpose of SLN biopsy is essentially to save the patient from the potential morbidity of the unnecessary axillary dissection and to save money. However, there are still striking difficulties, which can not be ignored in the process to make SLN biopsy as an alternative technique to axillary dissection. In this review article, SLN biopsy in breast cancer was analysed in the following headlines: how to fmd SLN ?, false negativity, diagnostic value of SLN biopsy, is primary tumor size important for SLN metastasis ?, SLN biopsy should be performed on which cases?, location of SLN, pathologic procedure, occult metastatis and their clinical significance, meaning of immunohistochemistry: is positive staining by cytokeratins diagnostic for malignancy, is the size of SLN metastasis important with respect to the presence of additional axillary Iymph node involvement?, diagnostic value of additional techniques, intraoperative diagnosis: is it necessary?, on which technique?