Does a positive sentinel lymph node always require completion dissection?

摘要

Over the past 10-15 years, sentinel lymph node (SLN) biopsy (SLNB) has become the standard of care in the management of breast cancer, limiting completion axillary lymph node dissection (cALND) to patients with positive sentinel nodes. Non-SLN metastases are present in 40-50% of SLN-positive patients [1,2] and are predicted by the same variables that may predict metastasis to the SLN, the most important being tumor size and lymphovascular invasion. Several groups have developed models for patients with a positive SLN to predict the likelihood of having additional positive non-SLNs.