David W. Kinne, MD

As Dr. Cody points out, sentinel lymph node mapping of axillary nodes in patients with invasive breast cancer will probably become the standard of care for patients with early breast cancer, and will replace standard axillary dissection for many of these patients. With mammography increasing the detection of small, nonpalpable breast cancers, which pose a very low risk of axillary metastases, it is difficult to justify the continued use of standard axillary dissection. To my mind, it is also difficult to justify omitting axillary dissection of any type in these settings.