Axillary dissection provides important staging information that can be used to estimate prognosis and subsequently to plan further systemic and radiation treatment. Axillary lymphadenectomy provides excellent long-term regional control from nodal metastases and may well have an impact on survival. Many techniques have been used and their use has been reviewed. Essentially, the SLN is the primary node that receives lymphatic drainage from a tumour, and its pathologic status appears to reflect the status of the nodal basin. Currently, there is tremendous interest in SLN bipsy from both surgical and patient communities.
Many surgeons are keen to learn the technique and incorporate the procedure into their practice.
If an SLN cannot be successfully identified, then the standard levels I and II axillary node dissection should be done. I and II axillary dissection in randomized clinical trials of clinically node-negative breast cancer patients. All centres are encouraged to participate in these trials. I and II axillary dissection as part of standard breast cancer treatment. Our recommendation is that Canadian general surgeons plan to acquire the necessary equipment, collaborate with their nuclear medicine and pathology colleagues to build an expert team, complete a recognized training program designed to teach the technique and perform a minimum of 30 SLN biopsies with concurrent levels I and II axillary lymph-node dissections in order to document proficiency and accuracy.