Carcinoma of the breast is the most common cancer among women, excluding sk
in cancer, and is the second leading cause of cancer-related deaths in wome
n. The American Cancer Society estimates that in 1998 approximately 178,700
new cases of invasive breast cancer will be diagnosed and 43,500 deaths fr
om breast canter will occur in women.(4) With the aging of the "baby boomer
" population, the incidence of the disease will increase. The decrease in t
he mortality rate of breast The most accurate predictor of survival in brea
st cancer is the presence or absence of lymph node metastases. Lymphatic ma
pping with sentinel node biopsy is a new technique that provides more accur
ate nodal staging compared with routine histology for women with breast can
cer, but without the morbidity of a complete lymph node dissection. Sentine
l lymph node (SLN) biopsy is a more conservative approach to the axilla tha
t requires close collaboration from the surgical team, nuclear medicine, an
d pathology. National trials are investigating the clinical relevance of th
e upstaging that occurs with a more intense examination of the SLN. As is t
he case with breast preservation as a viable alternative to mastectomy for
the definitive treatment of the primary node, selective lymphadenectomy has
the ability to decrease morbidity without compromising patient care.