Widespread Adoption of Sentinel Node Biopsies Questioned

Sentinel node biopsies are now being routinely performed on many women following surgery for early-stage breast cancer and some experts worry that this may be premature, according to a report in the Journal of the National Cancer Institute.

Sentinel node biopsy, in which surgeons remove only the lymph node believed at greatest risk for the spread of breast cancer, is increasingly being performed in place of standard removal of all the lymph nodes in the armpit area, which sometimes results in lymphedema (arm swelling caused by the blockage of lymph flow).

Large trials are currently under way aimed at determining whether sentinel node biopsies detect the spread of cancer as well as the removal of all the lymph nodes, and the concern is that premature widespread adoption of sentinel node biopsies as standard care may compromise these trials.

Reporting in the Journal of the National Cancer Institute, Dr. Stephen B. Edge of the Roswell Park Cancer Institute said the use of sentinel node biopsies alone appeared to increase from 8 percent of women treated for early breast cancer in 1997 to 58 percent of the women treated in the last half of 2000.

"Whether widespread use of sentinel node biopsies represents good clinical judgment or an example of premature adoption of an inadequately tested new technology is a question that may only be resolved many years from now when, and if, the ongoing clinical trials provide definitive data on the outcomes of this technique," Edge said.

Other Sources: Journal of the National Cancer Institute