What are the criteria for having a sentinel lymph node biopsy rather than a full axillary lymph node biopsy?
Answer by Peter Beitsch, MD
The vast majority of women with breast cancer should be getting no more than a sentinel lymph node biopsy. The exceptions are patients that have large (clinically positive) lymph nodes at the time of their diagnosis that have undergone a biopsy of their lymph node that shows cancer(fine needle aspiration or needle core biopsy typically). Women undergoing lumpectomy who have 1-2 sentinel nodes with cancer in them can now forego a completion dissection based on the recent ACOSOG study - Z0011 that was published in JAMA in February. The caveat is that they have to have whole breast irradiation (not partial breast irradiation). Also this does not apply to patients having a mastectomy (with or without reconstruction). If they have a positive sentinel node, they should have a completion dissection.
