4.4.5 Some Controversial SLNBs
（1）Preventive mastectomy High-risk patients may consider receiving SLNB when performing preventive mastectomy.
（2）SLNB is recommended when the scope of the catheter in situ cancer to receive breast preservation surgery may affect the subsequent SLNB.
（3）The overall false negative rate of SLNB clinical trials showing the clinical negative of the armpit lymph nodes after the new assisted treatment of the armpit lymph nodes is still difficult to meet clinical needs，but SLN negative patients who meet the following conditions can avoid ALND after full communication with the patient：CT1N1，double tracotic agent imaging，detection of 3 SLN，new auxiliary chemotherapy pre-sicasilla.
（4）Pregnant patients are not recommended for SLNB for pregnant patients due to possible allergic reactions of blue dye tracers.Radionuclide tracers are proven to be safe for the fetus，but full communication with the patient is still recommended.(https://www.daowen.com)
（5）Part of the study of the history on same-side armpit surgery was successful again in patients with the recurrence of the same breast after breast preservation and armpit surgery.The regional relapse risk of ALND in rSLNB-negative patients was low，and the very low recurrence rate supported its re-initial lymph node stage technique as a patient with the same side breast recurrence.
（6）cN0/image abnormal puncture armpit lymph node positive SLN positive clinical trials，such as ACOSOG，Z0011，AMAROS，IBXSG23-01，etc.are not required to cNO patients routine lymme imaging.
cNO/image abnormality punctured armpit lymph nodes patients who comply nith ACOSOG and Z0011 test，SLNB showed that only half of the positive patients were tested.Therefore，if the clinical physical examination of this part of the patient satnegative can meet the relevant clinical trial into the group conditions，it can enable more patients to avoid ALND and its complications.