Dr. Debu Tripathy MD Sentinel lymph node biopsy (SNL) and evolving standards of care.
Description: Sentinel lymph node biopsy (SNL) and evolving standards of care. The use of SLN has decreased the morbidity of patients with invasive breast cancer by significantly lowering the number of patients that need to undergo full axillary lymph node dissection (ALND). Up to 20% of patients with ALND develop lymphedema, and only about 5% develop this after SLN. Outcomes in terms of local and distant recurrence are equivalent in patients who present with a clinically negative axilla. However, in about 1/3 of patients, the SNL will be positive for cancer, and full ALND is recommended. The ACOSOG Z0011 study showed that in the short term, recurrence rates are no different in patients with up to 3 positive SLNs who do not undergo a completion ALND compared to those that do not. While further follow-up is needed, the standard of care might slowly evolve to skipping a full ALND even with positive SLNs unless decisions about systemic or radiation therapy will depend on the status of the unremoved nodes.
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Posted on : 08/16/10
Added : 9 years ago