Intraoperative Assessment of Sentinel Lymph Nodes in Breast Cancer

Lymph node status has been considered as an important prognosticindicator for survival in breast cancer. Recently the need for axillary clearanceand the significance of performing sentinel node biopsy has been questioned. Despite this, sentinel lymph node biopsy is considered as a standard method of assessment of clinically node-negative breast cancers. Economicimplications as well as patient related factors have led to the development a number of intraoperative techniques. Review of the emerging trends of practice in the last 4 years show that although routine histological examination remains the gold standard in most centres, intraoperative assessment remains the most favourable, timely and cost-effective option to analyse sentinel nodes. Molecular techniques appear to be far more superior to other histological tests such as frozen section or touch imprint cytology. Emerging research suggests that molecular techniques can be used to predict the presence of nonsentinel node metastasis. As a result, this technique may be a reliable surrogate to evaluate axillary tumor burden.