Updated: November 2004

Sentinel lymph node biopsy for breast cancer patients requires a multidisciplinary approach, coordinating the efforts of radiology, surgery and pathology divisions.  Appropriate training and skills development is mandatory.

In general, indications include women with T1 and T2, clinically N0 breast cancers.

Contraindications include patients with advanced breast cancer, multifocal cancers, previous disruptive breast procedures (surgery, radiation), palpable axillary nodes, adverse reactions to vital dyes.

All patients should undergo level 1 and level 2 axillary dissection if:

1. the sentinel node(s) are reported positive for malignancy
2. the surgeon is unable to identify a sentinel node or
3. as part of the surgeon's training and validation process