Sentinel node biopsy in breast cancer

A promising technique, but it should not be introduced without proper trials 

The status of the axillary lymph nodes in a woman with breast cancer is the single most important prognostic factor, and important clinical decisions are based on it. In the absence of non-invasive methods, it has become routine either to perform a partial axillary dissection to stage the axilla or to remove completely all axillary lymph nodes to both stage and treat the axilla. With the development of screening, increasing numbers of women are seen who are node negative. In these patients extensive axillary surgery is difficult to justify because most women gain no significant benefit and suffer considerable morbidity from the axillary surgery. Research has focused on developing procedures that assess axillary lymph node status while minimising morbidity.

Twenty years ago Cabanas showed the existence of a specific draining lymph node, the so called “sentinel” lymph node, which could be identified after lymphangiography through the dorsal lymphatics of the …