Sentinel lymph node biopsy: Sentinel node technique has drawbacks

doi:10.1136/bmj.329.7458.170-b

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

Letter

Sentinel lymph node biopsy

Sentinel node technique has drawbacks

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

EDITOR—Among the possible drawbacks of sentinel node biopsy,discussed by Kell and Kerin,¹ is the risk of false positivefindings because of reactive lymph node swelling in the biopsysite. Periodic follow up of the sampled lymph node area hasbecome a common practice after sentinel node biopsy, mostlybased on palpation and ultrasonography. Swelling of axillaryor inguinal lymph nodes reactive to sentinel node biopsy islikely to occur; a reaction in these sites is a common event,even after lesser injuries.

Unfortunately, both palpation and ultrasonography are poorlyaccurate in assessing enlarged nodes, and false positive reportsare likely to occur: fine needle aspiration may help, if positive,but considering that in these cases a greater diagnostic aggressivenessis expected, a false positive assessment might end in furthersurgical biopsy of the lymph node. A more aggressive surveillanceregimen is expected in patients undergoing sentinel node . . . [Full text of this article]

Stefano Ciatto, head

Department Diagnostic Imaging, Centro per lo Studio e la Prevenzione Oncologica, Viale Volta 171, I-50131, Florence, Italy s.ciatto@cspo.it