T. Wendler, S. Paepke Axillary sentinel node aspiration biopsy: towards minimally invasive lymphatic staging in breast cancer Clinical and Translational Imaging volume 4, pages377–384. https://doi.org/10.1007/s40336-016-0205-8 (bib)
	The last 5 years have been marked by major changes in the approach used to diagnose and treat disease in the axilla for breast cancer patients. Among the current controversies the sentinel lymph node biopsy has been put in question, at least for selected groups of patients. Making of the currently surgical procedure a minimally-invasive one, may be the way between abandoning the sentinel lymph node biopsy and keeping an invasive method of diagnostics. In order to implement a non-surgical needle-based procedure new imaging technologies have arisen in the last years. Freehand SPECT/ultrasound, contrast-enhanced ultrasound and photo-acoustic imaging using dyes for lymphatic mapping enable all to distinguish on the real-time ultrasound image sentinel lymph nodes from others. If combined with large volume needle-biopsy techniques like aspiration-based, freezing-based, pneumatic-driven or cauterization systems, extracting a significant amount of the sentinel lymph node(s) is possible. This opens new technical options towards a non-surgical sentinel lymph node biopsy in the axilla, which for the sake of terminology we name axillary sentinel node aspiration biopsy (a). This work summarizes the current state of art in the technology needed for SNAB and points out challenges and pitfalls, but also the fact that physicists and engineers have done their work and it is up to the medical community to evaluate its usefulness.
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