Sentinel lymph node – historical background and current views on its significance in complex management of breast cancer patients

Abstract

Nowadays, breast cancer is the leading oncological diagnosis in women worldwide. On the other hand, breast cancer treatment can be considered one of the most progressive therapeutic approach in the medical fi eld of oncology. The invasive types of breast cancer have a tendency to spread via lymphatic route, what brings in the issue of sentinel lymph node-the fi rst node into which the lymph drains from a given anatomical location. This review paper discusses the historical background of the concept of sentinel lymph node and focuses on clinical signifi cance of the positivity of sentinel lymph node(s) as well. Modern-day conservative therapeutic surgery of breast cancer should be in accordance with diagnostic and preventive interventions in the axilla, whose rate of invasiveness and morbidity must be also attenuated without worsening the patient´s prognosis and survival rate. Formerly, a complete axillary lymph node dissection was routinely performed for prophylactic and cancer staging purposes. The indiscriminate application of this approach was replaced by sentinel lymph node biopsy. Along with common histopathological examination, immunohistochemistry, as well as modern techniques of molecular biology are often employed. These state-of-the-art methods enabled the identifi cation of micrometastases, or even nanometastases, though their real prognostic value is yet to be concluded (Ref. 52).

Correlation between the risk of lymph node metastasis and the expression of GBP1 in breast cancer patients

“…When the cell tissue becomes cancerous, CEA differentiates from endoderm cells into cell membrane structural proteins, forms in the cytoplasm, and is secreted into the body through the cell membrane. 27 , 28 CEA expression is relatively stable and represents the normal operation of blood vessels and can also be used as an indicator of endocrine function. 29 However, when breast cell disease occurs, CEA will increase abnormally, and overexpression will also induce the production of excessive protein tyrosine kinase, suggesting CEA expression level is closely related to the process of LNM in BC.…”

Role of sentinel lymph node biopsy for gynecologic cancers

“…The term sentinel lymph node (SLN) was first coined in 1960 by Gould et al [1] during the study of parotid gland carcinoma. In 1992, the first application of SLN biopsy was described in early-stage melanoma, and has been widely accepted as a component of the surgical practice of that and breast cancer [2]. Since then, the concept of SLN detection and biopsy has been expanded to gynecologic malignancies [3].…”