Sentinel lymph node micrometastases and isolated tumor cells in breast cancer: An evolving field

Controversy still remains regarding appropriate surgical management and prognostic implications of micrometastases and isolated tumor cells (ITCs) in sentinel lymph nodes (SLNs) of breast cancer patients. There are two issues: First, is the follow-up completion axillary lymph node dissection (ALND) necessary after a diagnosis of ITCs or micrometastases in sentinel lymph node? Second, does sentinel lymph node micrometastases or ITCs carry any prognostic significance?