[Sentinel lymph node biopsy and low axillary node sampling for breast cancer].
Since sentinel lymph node(SLN) biopsy has a higher negative predictive value than that of four-node sampling, SLN biopsy might become the new acknowledged standard of clinical care for patients with early breast cancer. SLN biopsy is widely used in Western countries despite the lack of data from randomized trials. Clinical practice guidelines document that SLN biopsy should be performed with prudent informed consent and thorough surgical technique. Before surgeons replace axillary dissection with SLN biopsy as the staging procedure at their institution, they should perform backup axillary dissection until a detection rate of more than 90% and a false-negative rate of less than 5% are achieved. Recently, SLN biopsy has more often been indicated for multicentric breast cancer, larger tumors, prior excisions, and noninvasive carcinoma. While SLN biopsy is widely used in Western countries, there is little experience in Japan. If randomized studies, clinical practice guidelines, and the coverage of lymphoscintigraphy under health insurance were introduced, SLN biopsy would be used more widely in Japan.
Sawai
Kiyoshi
K
Department of Endocrine & Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Nakajima
Hiroo
H
Ohe
Shinya
S
Mizuta
Naruhiko
N
Sakaguchi
Kouichi
K
Hachimine
Yasushi
Y
D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000592:standards; D013048:Specimen Handling