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Sentinel lymph node biopsy

BMJ 2004; 328 doi: (Published 03 June 2004) Cite this as: BMJ 2004;328:1330
  1. Malcolm R Kell (, senior specialist registrar,
  2. Michael J Kerin, consultant surgeon
  1. Breast Check Eccles Unit, Department of Surgery, Mater Misericordiae Hospital, Dublin 7, Ireland

    Is now an established and widely available technique for breast cancer and melanoma

    Sentinel lymph node biopsy has developed over the past decade as a minimally invasive technique to assess regional lymph node status in patients with malignancy. This technique allows us to find out the status of a lymph node basin by removing only a small number of nodes. These nodes stand sentry to the rest of the nodal basin: if malignant disease is going to affect a nodal region it must first pass through the sentinel node. Therefore the nodal basin will contain malignant cells only if the sentinel node is first involved. The specific and limited removal of the sentinel node reduces surgical insult and morbidity compared with conventional lymphatic clearance. Sentinel lymph node biopsy is now widely available, and most cancer surgeons offer this as part of their diagnostic protocol for patients.

    Sentinel lymph node biopsy was initially developed to detect lymphatic metastasis in parotid carcinoma.1 As this technique has developed it has been used in the management of penile carcinoma, but it is now predominantly used in the diagnosis of lymphatic metastasis from breast cancer and melanoma.24 It can also be used to detect …

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