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Axillary lymph node dissection (ALND) reliably identifies lymph node metastases and results in a
high rate of local cancer control, even in patients who initially present with node-postive disease.
In patients initially presenting with node-negative breast cancer, ALND has been replaced by
sentinel lymph node (SLN) biopsy. Sentinel lymph node biopsy involves injecting dye or tracer
substances into the breast to selectively identify and remove the lymph nodes most likely to contain
metastases. This is a much less morbid procedure than ALND.
Morrow M, Dang CT. Sentinel Node Biopsy After Neoadjuvant ChemotherapyA New Standard for Patients With Axillary Metastases?. JAMA. 2013;310(14):1449-1450. doi:10.1001/jama.2013.7844