LYMPHATIC MAPPING IN THE TREATMENT OF BREAST-CANCER

Developed initially for the treatment of malignant melanoma, lymphatic mapping and sentinel lymph node biopsy have recently been introduced into the treatment of early breast cancer. In breast cancer patients, harvested sentinel lymph nodes are evaluated more thoroughly by detail ed pathologic examination using serial sectioning, immunohistochemistr y, and reverse transcriptase-polymerase chain reaction (RT-PCR) techni ques. This allows for the detection of smaller tumor volumes and leads to more accurate staging. Lymphatic mapping has a 68% to 98% success rate in identifying the sentinel lymph node. The false-negative rate ( defined as a negative sentinel lymph node while a higher node or nodes in the axilla are positive) is between 0% and 2%. The morbidity assoc iated with this procedure is minimal. We believe that lymphatic mappin g and sentinel lymph node biopsy will ultimately lead to more conserva tive treatment of patients with breast cancer. This article describes the historical background and technical aspects of the procedure. This is followed by updated, prospectively collected outcomes data from 46 6 consecutive breast cancer patients who underwent lymphatic mapping a t the H. Lee Moffitt Cancer Center, as well as an up-to-date review of the literature.