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Sentinel Lymph Node Biopsy
The status of the axillary lymph nodes is considered to be the most important prognostic indicator in women with breast cancer. The only way to know for sure of their involvement is to study them under the microscope. In the past, full lymph node dissection was used because of this significance. However, full lymph node dissection is associated with complications that include numbness, decreased range of motion, seromas, lymphedema and infections. Today over 60% of women are lymph node negative at the time of their presentation so a full dissection actually yields little clinical information and no survival advantage. The sentinel lymph nodes represent the first set of lymph nodes a tumor is going to drain to and if found to be uninvolved allows us to leave the remaining lymph nodes in place. This procedure, which requires special training and experience, is associated with a much lower complication rate and actually increases the accuracy of axillary staging. It is considered the standard of care in axillary staging today and has also been successfully used following neoadjuvant or up-front chemotherapy.
 
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