The sentinel node dilemma in breast cancer surgery

Amsterdam, The Netherlands, April 12, 2011 – The sentinel node (SN) procedure in breast cancer is based on the premise that if the first node into which breast tissue drains is clean, the remaining lymph nodes in the armpit are likely not involved, with no need for removal. This was developed to limit surgical overtreatment and reduce morbidities such as blockage of lymph vessels and shoulder dysfunction. However, in the initial years of the SN procedure, surgeries actually increased when isolated tumor cells were found. A special issue of Breast Disease presents an insightful overview of the Sentinel Node procedure.

"An increasing amount of evidence is becoming available on nodal isolated tumor cells and micrometastases since the introduction of the SN procedure," commented the issue's Guest Editor, Prof. Dr. Vivianne C.G. Tjan-Heijnen, Chair Oncology Committee MUMC, Head Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands. "Data on a number of randomized studies are expected in the next few years. To this end, this issue of Breast Disease provides an overview of current evidence that may be supportive in making the best decision in current patient care."

The introduction of population-based breast cancer screening and an increased awareness in the general population regarding breast lumps has resulted in a shift towards clinically node-negative breast cancer stages. Today, about 60% of breast cancer patients have pathologically node-negative disease.

Source: IOS Press