Fast Five Quiz: Breast Cancer Presentation and Diagnosis

Pavani Chalasani, MD, MPH; Stefania Morganti, MD


January 11, 2023

A sentinel node biopsy has become the standard of care for breast cancer staging and prognosis; it determines whether the cancer has spread into the lymphatic system beyond the site of the primary tumor. With the use of methylene blue dye or a radioactive sulfur colloid, the lymph node closest to the tumor can be identified.

Lymphedema following sentinel node biopsy is usually rare (~5%).

Women diagnosed with ductal carcinoma in situ may be candidates for breast-conserving surgery or mastectomy. According to the NCCN guidelines, a sentinel node biopsy may be considered in women with ductal carcinoma in situ treated with mastectomy. Patients treated with breast-conserving surgery should not have a biopsy.

Sentinel node biopsy should be considered for women with early-stage breast cancer under 70 years old. Conversely, the 2016 Society of Surgical Oncology Choosing Wisely guidelines recommended against routine sentinel lymph node biopsy in women age 70 years or older with favorable, early-stage breast cancer, as sentinel lymph node biopsy does not decrease recurrence or mortality in these patients.

Sentinel node biopsy is not recommended for women with large or locally advanced disease, inflammatory breast cancer, those who have received preoperative systemic therapy, or those who are pregnant.

Learn more about presentation and diagnosis of breast cancer.

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