Sentinel lymphadenectomy has replaced axillary lymph node dissection as a staging tool in early breast cancer. To be accepted as a standard of care, it had to pass successfully through a long journey which started in the early 1990s.
We carried out a comprehensive literature review focusing on the journey of the use of sentinel lymph node biopsy (SLNB) in breast cancer from its start until its current station, including the variable clinical applications, the current debates, and the future issues.
Adoption of sentinel lymph node biopsy as a standard axillary staging procedure was a marvelous trend that helped to decrease the complications of axillary dissection and significantly improve the quality of life of patients with breast cancer. Various mapping techniques can be used for SLN localization, rendering oncology centers that have variable capabilities and preparations able to perform the procedure. This applies to specimen processing techniques as well. Many debates faced the researchers throughout the SLNB journey. They are all explained in the current article, in addition to the ongoing trials and the future aspects of SLNB in breast cancer.
Further research should be conducted to help resolve the clinical issues which are still debatable and to provide bases for improving the future trends which are progressing towards limiting the role of axillary dissection and axillary surgery to the minimum required level.