Current Status of Sentinel Node Surgery in Breast Cancer
December 01, 2003
Krag and Harlow believe thatsentinel lymph node biopsyfor breast cancer is still an experimentalprocedure because “longtermrandomized trials comparing thesurvival outcome of this procedurewith that of conventional axillary noderesection have not been completed.”Specifically, they are awaiting the resultsof the American College of SurgeonsOncology Group (ACOSOG)Z0011 trial and the National SurgicalAdjuvant Breast and Bowel Project(NSABP) B-32 trial before they makea determination about the “safety” ofthis procedure. This is a commonmisconception, because these studieswill not prove whether sentinel nodebiopsy results in equivalent survivalcompared to standard level I/II axillarydissection in patients with clinicallynode-negative breast cancer. Thetime has come for clear thinking aboutthe design of these trials and precisereasoning about the interpretation oftheir ultimate results.