State of the art of sentinel node biopsy in oncology

Sentinel node biopsy has become a standard diagnostic procedure to assess l ymph node status of various tumors. The combination of blue dye and a radio active tracer offers the best chances of identifying the sentinel lymph nod e. Most progress in the technique of the sentinel node procedure has been m ade in melanoma and breast cancer. In melanoma, sentinel node biopsy has be en introduced as a fundamental procedure for staging. Information on the ly mphatic drainage from a melanoma can have a direct impact on the surgery. M ore recently, the technique has been successfully introduced in the managem ent of breast cancer, in which a large number of unnecessary axillary disse ctions could be avoided. However, there are many other potential fields of application of the sentinel node biopsy (e.g. endometrial, vulvar, head and neck cancers) that are worthy of investigation. In any case, multicenter t rials are required to standardize the procedures, taking into account sever al variables such as particle size and mode of delivery of the radiotracer, amount of radioactivity administered, number and location of injections, a nd choice of the hand-held probe. We briefly describe the technical and his torical aspects of the sentinel node biopsy and summarize the main clinical trials proposed and/or performed in the field.