Sentinel lymph node biopsy: Optimum method remains to be determined

doi:10.1136/bmj.329.7458.170-a

BMJ 2004;329:170 (17 July), doi:10.1136/bmj.329.7458.170-a

Letter

Sentinel lymph node biopsy

Optimum method remains to be determined

The first 150 words of the full text of this article appear below.

EDITOR—Kell and Kerin report on the current status ofsentinel lymph node biopsy in the surgical treatment of breastcancer and melanoma.¹ They say that the detection of occultmalignancy in lymph nodes in breast cancer signifies a worseprognosis and that the rapid intraoperative detection of malignantcells by immunocytochemistry will vitalise sentinel node biopsy—bothassertions may be premature. Although a number of earlier studieshave shown a worse prognosis, a more recent study using multivariateanalysis has indicated that occult metastases are of no independentprognostic importance.²

The optimum method by which lymph nodes removed in the courseof breast cancer surgery should be examined, including the utilityof immunocytochemistry, remains to be determined. Touch imprintcytology is a reliable method for the detection of carcinomacells, but may not reliably discriminate between macrometastases(deposits > 2 mm), micrometastases (deposits < 2 mm),and small numbers . . . [Full text of this article]

Ervine D Long, consultant histopathologist

ervine.long@hey.nhs.uk

John R Read, consultant histopathologist

Hull Royal Infirmary, Hull HU3 2JZ