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Sentinel Lymph Node Biopsy in Breast Cancer:

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Preservation of healthy lymph nodes may have beneficial consequences. Axillary dissection should not be performed in breast cancer patients without first examining the sentinel node.

The researchers conclude “the long-term breast cancer-related event-free survival in the (sentinel node-based dissection) arm was similar to that in the (routine dissection) arm, enabling us to affirm not only that sentinel node biopsy is as good as complete axillary dissection at staging the axilla, but that it is as safe as the once standard method of complete axillary dissection.

This finding is excellent because many women will be able to avoid the unnecessary removal of many valuable lymph nodes and avoid the complication of life-long lymphedema.  Also, the sentinel node biopsy avoids many of the surgical complications involved with full dissection.
The SNLB is far less risky and the risk of lymphedema is much reduced with this procedure.
 On a personal note, because I had the sentinel node biopsy in 2003 and it was negative for cancer spread, I am delighted to see these results.  There were early and promising results at the time, but a ten-year study is very affirming.

Mary Miller- Breast Cancer Profile in Courage


OBJECTIVE: Sentinel node biopsy (SNB) is widely used to stage the axilla in breast cancer. We present 10-year follow-up of our single-institute trial designed to compare outcomes in patients who received no axillary dissection if the sentinel node was negative, with patients who received complete axillary dissection.
 
METHODS: From March 1998 to December 1999, 516 patients with primary breast cancer up to 2 cm in pathologic diameter were randomized either to SNB plus complete axillary dissection (AD arm) or to SNB with axillary dissection only if the sentinel node contained metastases (SN arm).
 
CONCLUSIONS: Preservation of healthy lymph nodes may have beneficial consequences. Axillary dissection should not be performed in breast cancer patients without first examining the sentinel node.”
 “Sentinel lymph node biopsy has become a standard staging tool in the surgical management of BC. The positive impact of sentinel lymph node biopsy on postoperative negative outcomes in BC patients, without compromising the oncological outcomes, is its major advantage. It has evolved over the last few decades and has proven its utility beyond early breast cancer. Its applicability and efficacy in patients with clinically positive axilla who have had a complete clinical response after neoadjuvant chemotherapy is being aggressively evaluated at present. This article discusses how sentinel lymph node biopsy has evolved and is becoming a useful tool in new clinical scenarios of breast cancer management…

CONCLUSION: Sentinel node biopsy is the current paradigm in the management of regional basin in breast cancer. With continuous improvement in cure rates over the last few decades, limiting surgery and maintaining QOL have become important concepts in the management of breast cancer. SLNB has proven to be an efficacious and cost-effective tool in breast cancer. Its application has expanded beyond early breast cancer, and it has been established in areas where it was previously considered inapplicable. For instance, SLNB is gradually incorporated in the management of patients with cN+ axilla who are rendered cN0 after NACT.”

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