Just as laparoscopic surgery did in the late 1980s, sentinel lymph node biopsy (SLN) is a promising new medical technique that is gaining popularity before the medical community has had time to provide adequate training and put the procedure into practice in a safe and organized manner.
Although randomized trials evaluating SLN biopsy are underway, it will likely be a number of years before the results will be available. To help physicians and patients considering SLN biopsy, the Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer systematically reviewed the English-language literature published from January 1991 to December 2000.
Among the nine committee recommends are: that surgeons who perform breast cancer surgery infrequently not perform SLN biopsy, positive SLN biopsy results should prompt full axillary dissection; SLN biopsy is contraindicated in women with clinically palpable nodes, locally advanced breast cancer, multifocal tumours, previous breast surgery or previous irradiation of the breast.
Contact: Dr. Mark Levine, Faculty of Health Sciences, McMaster University Health Sciences Centre, Hamilton.
Canadian Medical Association Journal