Sentinel node biopsy in breast cancer is rapidly gaining acceptance as an appropriate diagnostic tool for determining whether cancer has spread to the surrounding lymph nodes. Large studies have validated the accuracy of this technique. Many centers now offer sentinel node biopsy and bypass axillary dissection if the sentinel node is negative. The National Comprehensive Cancer Network (NCCN) Breast Cancer Practice Guidelines Committee added standards for sentinel node biopsy to their guidelines in 1997 as a category 2 recommendation. Their suggestions address the criteria for patient selection, and the need for an experienced team of practitioners. Despite the rapid acceptance and proliferation of the technique, many questions remain regarding its use. They include defining the optimal material and technique to identify the sentinel node, patient selection, the role of biopsy of nonaxillary sentinel nodes, the role of immunohistochemical analysis of nodes to identify micrometastases, the situations under which complete axillary node dissection is indicated, and finally whether axillary dissection in the sentinel node-negative patient impacts survival. To address these questions, the American College of Surgeons Oncology Group and the National Surgical Adjuvant Breast and Bowel Project recently activated large-scale clinical trials of sentinel node biopsy in breast cancer. Oncologists in all disciplines should lend strong support to these protocols in the coining years.
|Original language||English (US)|
|Number of pages||6|
|Issue number||11 A|
|State||Published - Dec 1 1999|
ASJC Scopus subject areas
- Cancer Research