A radiographer's perspective of sentinel lymph node biopsy

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Axillary lymph node clearance during surgery for breast cancer provides control of local disease within the axilla and staging of axillary lymph nodes. However, the procedure carries a significant morbidity such as seroma formation, infection, parathesia-reduced shoulder movements, lymphoedema and longer in-patient stay. As there are a significant number of patients presenting with early stage breast cancer (60% of patients have disease free axillary nodes), routine axillary lymph node clearance exposes many patients to unnecessary surgery.

Sentinel lymph node biopsy has evolved as a technique to successfully identify the first draining lymph node to accurately predict axillary lymph node status. It is a minimally invasive procedure which, after an initial learning curve, is quick and easy to perform. At the University Hospital Birmingham NHS Trust, we are now involved in a national trial for this procedure. This is a review of the technique and imaging modalities involved. If shown to be a successful and reliable technique, sentinel lymph node biopsy will contribute significantly to the management of breast cancer patients.