Effect of sentinel-node biopsy on metastatic development in breast cancer

Abstract

Over the past few years, most studies of sentinel-lymph-node biopsy (SLNB) have been to validate the accuracy of the technique to predict whether axillary lymph nodes (ALN) will be positive or negative at ALN dissection (ALND). Although some of these studies have addressed the short-term morbidity of SLNB compared with standard ALND, 1 Rietman JS Dijkastra PU Geertzen JH et al. Short term morbidity of the upper limb after sentinel node biopsy or axillary lymph node dissection for stage I and II breast carcinoma. Cancer. 2003; 98: 690-696 Crossref PubMed Scopus (72) Google Scholar formal, randomised controlled trials are needed to establish the long-term effect of not resecting further lymph nodes when the SLN is negative. The effects of this procedure on locoregional control and overall survival need to be ascertained before this method can be accepted as standard of care, and the health economics need to be assessed before SLNB can be introduced into routine clinical practice. Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled studySLNB can allow total ALND to be avoided in patients with negative SLNs, while reducing postoperative morbidity and the costs of hospital stay. The finding that only one overt axillary metastasis occurred during follow-up of patients who did not receive ALND (whereas eight cases were expected) could be explained by various hypotheses, including those from cancer-stem-cell research. Full-Text PDF