Blue versus hot: Learning the techniques with dye and isotopes

Intraoperative lymphatic mapping and sentinel node (SN) biopsy has generated a tremendous amount of interest in the field of surgical oncology since its introduction for patients with early-stage melanoma. The SN concept has been applied recently to many solid tumors, including melanoma, breast cancer, thyroid cancer, gynecological malignancies, and colorectal cancers. Although the concept of intraoperative lymphatic mapping and SN biopsy has been validated in multiple single-institution studies as well as multicenter trials, there is still much discussion as to which mapping technique is easier to learn. This article focuses on the technical aspects of SN mapping in breast cancer and reviews the most recent data to try to determine which technique is superior.