Evolving Landscape of Intraoperative Evaluation of Sentinel Lymph Node Biopsy in Breast Cancer

Résumé fourni par la source

Background: Sentinel lymph node (SLN) biopsy has transformed breast cancer management by providing a minimally invasive method for axillary staging and reducing the need for extensive lymph node dissections. Following de-escalation trials such as ACOSOG Z0011, the role of intraoperative SLN evaluation has narrowed, especially for Z0011-eligible patients in whom SLN evaluation now rarely alters axillary management. Nevertheless, intraoperative SLN assessment remains valuable for immediate decision-making, potentially minimizing reoperation rates and improving patient outcomes. Methods: A literature review was conducted to evaluate intraoperative SLN assessment in breast cancer, with an emphasis on histopathological techniques. English-language articles from 2010 to 2025 were identified in PubMed using the combination terms “intraoperative,” “sentinel lymph node(s),” “breast cancer,” “histopathology,” “pathology,” and “frozen section.” This work was conceived as a narrative review; no formal systematic review procedures or meta-analyses were performed. Results: This review outlines the historical development of SLN biopsy, highlights key clinical trials supporting its use, and examines current intraoperative assessment techniques, including frozen section analysis, touch imprint cytology, and one-step nucleic acid amplification. The diagnostic accuracy and clinical relevance of each method are discussed, particularly in the context of low-volume disease such as micrometastases and isolated tumor cells, which rarely influence contemporary surgical or radiotherapy decisions. Conclusion: SLN biopsy remains central to breast cancer staging, but it can be safely omitted in selected patients with early-stage breast cancer. Emerging molecular-probe-based and artificial intelligence–assisted technologies will improve diagnostic accuracy and consistency in intraoperative assessment.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.