Sentinel lymph node assessment in breast cancer-an update on current recommendations

Virchows Arch. 2022 Jan;480(1):95-107. doi: 10.1007/s00428-021-03128-z. Epub 2021 Jun 23.

Abstract

Sentinel lymph node biopsy (SLNB) has become the preferred method of surgical pathological nodal staging of early breast cancer by the end of the nineties. As the most likely sites of metastasis, the SLNs allow a more precise staging, and indeed gross sectioning, step sectioning, immunohistochemistry, and molecular staging methods have been used to disclose metastatic involvement of these lymph nodes. This review summarizes the backgrounds of SLNB, trends in related surgery and pathology. It also gives an insight into European National recommendations related to SLN and divergent daily practices in European pathology departments, on the basis of replies to questionnaires from 84 pathologists from 38 European countries. The questionnaires revealed the post-neoadjuvant setting as an area where a significant minority of pathologists report less confidence in classifying residual nodal involvement into TNM categories. The review also summarizes the neoadjuvant therapy-related aspects of SLNB.

Keywords: Breast cancer; Lymph nodes; Neoadjuvant treatment; Questionnaire; Sentinel lymph nodes.

Publication types

  • Review

MeSH terms

  • Axilla / pathology
  • Breast Neoplasms* / pathology
  • Female
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnosis
  • Lymphatic Metastasis / pathology
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Sentinel Lymph Node Biopsy
  • Sentinel Lymph Node* / pathology