%0 Journal Article
%T Clinical aspects of sentinel node biopsy
%A Hiram S Cody
%J Breast Cancer Research
%D 2000
%I BioMed Central
%R 10.1186/bcr280
%X Some of the best ideas in clinical medicine are simple ones, and SLN biopsy is one of these. The hypothesis that one or a few lymph nodes receive the first drainage from a tumor site, and that a regional node dissection and its morbidity might be avoided if the SLNs prove negative, is logical and intuitive. First suggested by Cabanas [1] in the context of penile cancer and conceived in its modern form in a 1992 report by Morton et al [2], SLN biopsy is rapidly emerging as a new standard of care in melanoma and breast cancer. The procedure has promise but remains investigational in patients with head and neck, urologic, gynecologic, and colorectal cancers. SLN biopsy's immediate potential is greatest among patients with breast cancer, by far the most significant group numerically, and will be the focus of this overview. Among an estimated 184,200 new cases of breast cancer in the United States last year [3], about 60% (110,000) had disease limited to the breast and might have avoided a conventional axillary lymph node dissection (ALND) through SLN biopsy.By the end of 1999, 41 peer-reviewed pilot studies using radioisotope [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19] or blue dye [20,21,22,23,24,25,26,27,28,29,30] methods, or a combination of both [31,32,33,34,35,36,37,38,39,40,41,42] (Table 1), report the results of SLN biopsy validated by a 'backup' ALND in breast cancer patients. SLNs were identified in 90% of cases, correctly identified 93% of axillary node-positive individuals, and were the only site of nodal metastasis in 47% of these. An increasing number of centers, having completed validation studies of SLN biopsy, offer patients the option of no further axillary surgery if the SLN is negative. Despite this encouraging debut, SLN biopsy is a new operation, has a definite learning curve, and is highly multidisciplinary, requiring the cooperation of nuclear medicine physicians, surgeons, and pathologists. The techniques pertinent to each specialty continue to ev
%K breast cancer
%K lymph node metastasis
%K lymphoscintigraphy
%K sentinel node
%U http://breast-cancer-research.com/content/3/2/104