6 Clinical trials have proven that SLN is equivalent to staging of the axilla in patients with clinically node-negative (cN0) disease. Today, patients with breast carcinoma have smaller tumors and lower nodal disease burden compared with historical series, and most are treated with adjuvant systemic therapy, which is now recognized as improving local as well as systemic control. An SLN is the first lymph node draining a tumor bed, and as such it constitutes the first site of lymph node (LN) involvement. Sentinel lymph node (SLN) biopsy was implemented as an alternative procedure in order to minimize the negative impact of axillary surgery. 2– 5 Management of the axilla in patients with breast carcinoma has evolved rapidly in recent years, and an increasingly conservative approach to axillary staging has been developed. 1 Axillary lymph node dissection, however, is associated with significant morbidity, including long-term complications such as limitation of shoulder movements, paresthesias and arm numbness, and lymphedema, which can have a significant impact on the patient's quality of life. For decades, ALN dissection (ALND) was the only procedure used for staging ALNs in women with invasive breast carcinoma. Axillary lymph node (ALN) status is an important prognostic factor and determinant of treatment for patients with breast carcinoma.
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