Abstract
During the recent years, based on the results of validation studies, the sentinel lymph node biopsy has replaced routine axillary dissection as the new standard of care in early breast cancer. The technique represents a minimally invasive, highly accurate method for axillary staging, which could spare approximately 65-70% of patients unnecessary axillary dissection and its related morbidity Several technical and clinical controversies have been raised during the development of this new technique; the authors review the most important issues, some questions have already been answered and others are still under debate. As far as the technical aspects are concerned, mapping techniques, appropriate surgical training, options for pathological examination of sentinel lymph nodes and the issue of nonaxillary sentinel lymph nodes are discussed. An update on clinical controversies demonstrates that factors such as large tumor size, palpable axillary nodes, multifocality and multicentricity, previous breast and axillary surgery, and pregnancy are no longer regarded as absolute contraindications for sentinel lymph node biopsy. Feasibility, accuracy and timing of sentinel lymph node biopsy in patients undergoing neoadjuvant chemotherapy remain unsolved issues, as well as the indication of the technique for some subgroups of in situ lesions. Finally, one of the most attractive open forums for debate will be discussed: Whether or not completion of axillary dissection in the case of positive SLN is always required.
| Original language | English |
|---|---|
| Pages (from-to) | 1503-1515 |
| Number of pages | 13 |
| Journal | Expert Review of Anticancer Therapy |
| Volume | 6 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Nov 2006 |
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Keywords
- Breast cancer
- Breast surgery
- Clinical controversies
- Sentinel node biopsy
- Sentinel node micrometastasis
- Technical controversies
ASJC Scopus subject areas
- Cancer Research
- Pharmacology
Cite this
Sentinel lymph node biopsy as the new standard of care in the surgical treatment for breast cancer. / Ferrari, Alberta; Rovera, Francesca; Dionigi, Paolo; Limonta, Giorgio; Marelli, Marina; Ciani, Isabella Besana; Bianchi, Veronica; Vanoli, Cristiana; Dionigi, Renzo.
In: Expert Review of Anticancer Therapy, Vol. 6, No. 10, 11.2006, p. 1503-1515.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sentinel lymph node biopsy as the new standard of care in the surgical treatment for breast cancer
AU - Ferrari, Alberta
AU - Rovera, Francesca
AU - Dionigi, Paolo
AU - Limonta, Giorgio
AU - Marelli, Marina
AU - Ciani, Isabella Besana
AU - Bianchi, Veronica
AU - Vanoli, Cristiana
AU - Dionigi, Renzo
PY - 2006/11
Y1 - 2006/11
N2 - During the recent years, based on the results of validation studies, the sentinel lymph node biopsy has replaced routine axillary dissection as the new standard of care in early breast cancer. The technique represents a minimally invasive, highly accurate method for axillary staging, which could spare approximately 65-70% of patients unnecessary axillary dissection and its related morbidity Several technical and clinical controversies have been raised during the development of this new technique; the authors review the most important issues, some questions have already been answered and others are still under debate. As far as the technical aspects are concerned, mapping techniques, appropriate surgical training, options for pathological examination of sentinel lymph nodes and the issue of nonaxillary sentinel lymph nodes are discussed. An update on clinical controversies demonstrates that factors such as large tumor size, palpable axillary nodes, multifocality and multicentricity, previous breast and axillary surgery, and pregnancy are no longer regarded as absolute contraindications for sentinel lymph node biopsy. Feasibility, accuracy and timing of sentinel lymph node biopsy in patients undergoing neoadjuvant chemotherapy remain unsolved issues, as well as the indication of the technique for some subgroups of in situ lesions. Finally, one of the most attractive open forums for debate will be discussed: Whether or not completion of axillary dissection in the case of positive SLN is always required.
AB - During the recent years, based on the results of validation studies, the sentinel lymph node biopsy has replaced routine axillary dissection as the new standard of care in early breast cancer. The technique represents a minimally invasive, highly accurate method for axillary staging, which could spare approximately 65-70% of patients unnecessary axillary dissection and its related morbidity Several technical and clinical controversies have been raised during the development of this new technique; the authors review the most important issues, some questions have already been answered and others are still under debate. As far as the technical aspects are concerned, mapping techniques, appropriate surgical training, options for pathological examination of sentinel lymph nodes and the issue of nonaxillary sentinel lymph nodes are discussed. An update on clinical controversies demonstrates that factors such as large tumor size, palpable axillary nodes, multifocality and multicentricity, previous breast and axillary surgery, and pregnancy are no longer regarded as absolute contraindications for sentinel lymph node biopsy. Feasibility, accuracy and timing of sentinel lymph node biopsy in patients undergoing neoadjuvant chemotherapy remain unsolved issues, as well as the indication of the technique for some subgroups of in situ lesions. Finally, one of the most attractive open forums for debate will be discussed: Whether or not completion of axillary dissection in the case of positive SLN is always required.
KW - Breast cancer
KW - Breast surgery
KW - Clinical controversies
KW - Sentinel node biopsy
KW - Sentinel node micrometastasis
KW - Technical controversies
UR - http://www.scopus.com/inward/record.url?scp=33750713330&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33750713330&partnerID=8YFLogxK
U2 - 10.1586/14737140.6.10.1503
DO - 10.1586/14737140.6.10.1503
M3 - Article
C2 - 17069533
AN - SCOPUS:33750713330
VL - 6
SP - 1503
EP - 1515
JO - Expert Review of Molecular Diagnostics
JF - Expert Review of Molecular Diagnostics
SN - 1473-7159
IS - 10
ER -