Sentinel lymph node biopsy under local anesthesia in patients with breast cancer.

The concept of breast cancer treatment is changed from maximal tolerable treatment to minimal effective treatment. There has been a change from axillary lymph node dissection (ALND) to sentinel lymph node biopsy (SLNB). The current theory of breast cancer spreading to the axillary lymph nodes is established that if the metastatic cancer cell has spread to the axillary lymph node. The first node that receives the lymphatic drainage from the tumor is called sentinel lymph node. We can find the sentinel lymph node and examine it that there are cancer cells or not. If there are no cancer cells. It is not necessary to remove the remaining lymph nodes in the axillar. The method to find the sentinel lymph node is to inject isosulfan blue dye or Radio isotope into the breast area and dissect to find the first lymph nodes and send the sentinel node to the pathologist for examination by frozen section method. If there is no metastatic cancer cells in the lymph nodes, the surgeon can omit to do ALND.