Sentinel lymph node biopsy (SLNB) has become the preferred method of surgical pathological nodal staging of early breast cancer by the end of the nineties. As the most likely sites of metastasis, the SLNs allow a more precise staging, and indeed gross sectioning, step sectioning, immunohistochemistry, and molecular staging methods have been used to disclose metastatic involvement of these lymph nodes. This review summarizes the backgrounds of SLNB, trends in related surgery and pathology. It also gives an insight into European National recommendations related to SLN and divergent daily practices in European pathology departments, on the basis of replies to questionnaires from 84 pathologists from 38 European countries. The questionnaires revealed the post-neoadjuvant setting as an area where a significant minority of pathologists report less confidence in classifying residual nodal involvement into TNM categories. The review also summarizes the neoadjuvant therapy-related aspects of SLNB.

Department of Clinical Pathology Sahlgrenska University Hospital Gothenburg Sweden

Department of Health Sciences Division of Pathological Anatomy University of Florence Florence Italy

Department of Histopathology Breast Check Irish National Breast Screening Programme and St Vincent's University Hospital Dublin Ireland

Department of Pathology Bács Kiskun County Teaching Hospital Kecskemét Hungary

Department of Pathology University of Szeged Szeged Hungary

The Fingerland Department of Pathology Charles University Medical Faculty Hospital Hradec Kralove Czech Republic

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