Sentinel node biopsy in breast cancer: a promising technoque, but it should not be introduced without proper trials

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Author: Michael Dixon
Date: Aug. 1, 1998
From: British Medical Journal(Vol. 317, Issue 7154)
Publisher: BMJ Publishing Group Ltd.
Document Type: Editorial
Length: 970 words

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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 penis.[1] He confirmed that the first node visualised, the sentinel node, was the first site of metastases and reported that it was often the only affected lymph node. Unaware of this report, in 1992 Morton and colleagues developed cutaneous lymphoscintigraphy as a method of identifying nodal areas at risk of metastases in patients with malignant melanoma? They showed preferential drainage to one or two nodes in a particular lymph node group. Applying this concept to breast cancer, we would expect that if malignant cells spread to a regional lymph node then they...

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Source Citation
Dixon, Michael. "Sentinel node biopsy in breast cancer: a promising technoque, but it should not be introduced without proper trials." British Medical Journal, vol. 317, no. 7154, 1 Aug. 1998, p. 295+. Accessed 1 Oct. 2020.
  

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