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In the
therapeutic intervention of breast cancer, axillary lymph node involvement and
dissection is important to prevent recurrence. In some early breast cancer
cases with no axillary lymph node involvement, revision of the necessity of
axillary dissection has surfaced.

The introduction
of sentinel lymph node biopsy to unravel this dilemma does pose a few issues
for example the perpetuation of surgical period the and prolonged duration by
pathologist for comprehensive histological evaluation. Moreover, the are a
minority of cases in which the sentinel node was not singled out by this
examination. These disputes would in turn significantly impact the patient as
it affects the staging of breast cancer patients and subsequently, the
treatment rendered. In this new age of molecular imaging the dawn of hybrid
imaging 18 F flurodeoxyglucose positron emission tomography computer tomography
(18 F FDG PETCT) has given a new insight. 18 F FDG PETCT is credited as a novel
non invasive technique. Studies have shown that 18 F FDG PETCT has poor
sensitivity in detecting axillary node metastases in early breast cancer.

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However, based on
(U. Veronesi et al, A comparative study on the value of FDG-PET and sentinel
node biopsy to identify occult axillary metastases, we can conclude that when
axillary lymph node hypermetabolism is demonstrated, it deems the probability
of axillary lymph node metastatic deposits is of high suspicion. It would be
less time consuming and effective as these groups of patient would immediately
redirected for axillary dissection bypassing the need of SNB. However, given
the negative axillary lymph node evaluation on PET, its reliability is very low
and axillary sentinel lymph node biopsy is helpful 32.  





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