Study: Sentinel-Node Biopsy Seen Safe and Accurate

A sentinel node biopsy, in which doctors remove only one to three of the underarm lymph nodes for review by a pathologist, appears to be a safe and accurate method of screening for the spread of breast cancer, according to Italian researchers.

The procedure, which is performed in place of removal of all of the lymph nodes in the armpit adjacent to the cancerous breast, is viewed by some doctors as a better option that can help avoid the swelling, disfigurement and discomfort that sometimes follows the more aggressive surgery.

The theory is that if the sentinel nodes -- identified by a dye or radioactive tracer as the nodes receiving fluid from the tumor -- do not contain cancer cells, then it is likely that the other lymph nodes are cancer-free as well.

In a report on their study of 516 women, researchers at the European Oncology Institute in Milan, Italy, concluded sentinel-node biopsy only missed stray cancer cells about 9 percent of the time.

"There was less pain and better arm mobility in the patients who underwent sentinel-node biopsy only than in those who also underwent [full lymph node] dissection," the researchers reported.

But in an editorial in the New England Journal of Medicine where the report appeared, David Krag and Takamaru Ashikaga of the University of Vermont College of Medicine contended the Milan study was too small to resolve the controversy over whether sentinel node biopsies miss too many cancers.

"The conclusion that sentinel-node surgery does not result in reduced survival and therefore that it is a safe procedure ... must await the completion of larger clinical trials," they wrote.

Other Sources: New England Journal of Medicine