Abstract: With the rapid development of medical imaging techniques, the diagnosis of axillary lymph node metastases is improved in early stage breast cancer. The smaller and earlier metastatic lesion can be detected and identified by fine needle aspiration cytology or core needle biopsy, which may provide the entire axillary staging for patient. There are two prospective, multicenter, international randomized trials to compare axillary sentinel lymph node biopsy with no surgical staging for patients with negative axillary ultrasound imaging. Our center used contrastenhanced ultrasonography with microbubbles to identify the location of sentinel lymph node and guide its biopsy, which aimed to find an ultra-minimally invasive sentinel lymph node biopsy technique. The pre-operation imaging detection increased the detection rate of clinically positive axillary lymph node. However, it led some patients to lose the chance that they could receive axillary sentinel lymph node biopsy instead of axillary lymph node dissection. We also discussed whether sentinel lymph node biopsy suited cT1-2N0 patients who had 1-2 abnormal axillary lymph nodes detected by imaging technique and confirmed by fine needle aspiration cytology or core needle biopsy. Furthermore, the studies about internal mammary sentinel lymph node biopsy were reviewed.

Key words: Breast cancer, Sentinel lymph node biopsy, Imaging detection, Recent advances