PREOPERATIVE AXILLA EVALUATION - It is essential that patients receive adequate evaluation of the axilla prior to surgery. (See "Sentinel lymph node biopsy in breast cancer: Techniques".) ![]() The technique of sentinel lymph node mapping in patients with breast cancer is discussed separately. Indications for and outcomes of sentinel lymph node biopsy will be reviewed here. (See "Overview of management of the regional lymph nodes in breast cancer" and "Prognostic and predictive factors in metastatic breast cancer", section on 'Prognostic versus predictive factors'.) Sentinel lymph node biopsy has replaced axillary lymph node dissection in most patients with early breast cancer. When the axilla is clinically negative by palpation and ultrasound examination, the pathologic node-positive rate decreases to approximately 18 percent.Īxillary dissection has traditionally been used in breast surgery to obtain lymph nodes. Histologic examination of lymph nodes is the most accurate method for assessing lymph node metastasis approximately one in four patients with clinically negative lymph nodes will have pathologically identified nodal metastases. ![]() INTRODUCTION - The status of the axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer.
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