Skip to main content
Log in

Controversies in sentinel node biopsy for breast cancer

  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Sentinel node biopsy for breast cancer patients has recently been applied as a less invasive, highly accurate alternative to axillary lymph node dissection. Numerous studies have shown that sentinel nodes accurately diagnose axillary staging. However, many problems remain to be answered and must be addressed before sentinel node biopsy becomes the standard surgical procedure for patients with breast cancer. We reviewed and discussed here three of these problems; axillary sampling as an alternative to sentinel node biopsy, dye method vs. combination of dye and radiocolloid for sentinel node biopsy, and intraoperative sentinel node examination. Further investigation will continue to be necessary as we learn how to better provide procedure of sentinel node biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hayward J: The Guy’s trial of treatment of early breast cancer.World J Surg 1:314–316, 1998.

    Article  Google Scholar 

  2. Cabanes PA, Salmon RJ, Vilcoq JR, Durand JC, Fourquet A, Gautier C, Asselain B: Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer.Lancet 339:1245–1248, 1992.

    Article  PubMed  CAS  Google Scholar 

  3. Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N: Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation.N Engl J Med 347:567–575, 2002.

    Article  PubMed  Google Scholar 

  4. Krag DN, Weaver DL, Alex JC, Fairbank JT: Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe.Surg Oncol 2:335–339, 1993.

    Article  PubMed  CAS  Google Scholar 

  5. Giuliano AE, Kirgan DM, Guenther JM, Morton DL: Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 220:391–401, 1994.

    Article  PubMed  CAS  Google Scholar 

  6. Giuliano AE, Jones RC, Brennan M, Statman R: Sentinel lymphadenectomy in breast cancer.J Clin Oncol 15:2345–2350, 1997.

    PubMed  CAS  Google Scholar 

  7. Motomura K, Inaji H, Komoike Y, Kasugai T, Nagumo S, Noguchi S, Koyama H: Sentinel node biopsy in breast cancer patients with clinically negative lymphnodes.Breast Cancer 6:259–262, 1999.

    Article  PubMed  Google Scholar 

  8. Motomura K, Inaji H, Komoike Y, Kasugai T, Noguchi S, Koyama H: Sentinel node biopsy guided by indocyanin green dye in breast cancer patients.Jpn J of Clin Oncol 29:604–607, 1999.

    Article  CAS  Google Scholar 

  9. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, Feldman S, Kusminsky R, Gadd M, Kuhn J, Harlow S, Beitsch P: The sentinel node in breast cancer-A multicenter validation study.N Engl J Med 339:941–946, 1998.

    Article  PubMed  CAS  Google Scholar 

  10. Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, Costa A, de Cicco C, Geraghty JG, Luini A, Sacchini V, Veronesi P: Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes.Lancet 349:1864–1867, 1997.

    Article  PubMed  CAS  Google Scholar 

  11. Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, Shivers S, Berman C, Wells K, Rapaport D, Shons A, Horton J, Greenberg H, Nicosia S, Clark R, Cantor A, Reintgen DS: Lymphatic mapping and sentinel node biopsy in the patient with breast cancer.JAMA 276:1818–1822, 1996.

    Article  PubMed  CAS  Google Scholar 

  12. Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, Ku NN, Lyman GH, Berman C, Haddad F, Reintgen DS: Guidlines for sentinel node biopsy and lymphatic mapping of patients with breast cancer.Ann Surg 227:645–653, 1998.

    Article  PubMed  CAS  Google Scholar 

  13. Tafra L, Lannin DR, Swanson MS, Van Eyk JJ, Verbanac KM, Chua AN, Ng PC, Edwards MS, Halliday BE, Henry CA, Sommers LM, Carman CM, Molin MR, Yurko JE, Perry RR, Williams R: Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye.Ann Surg 233:51–59, 2001.

    Article  PubMed  CAS  Google Scholar 

  14. Zervos EE, Burak WE Jr: Lymphatic Mapping for Breast Cancer: Experience at the Ohio State University.Breast Cancer 7:195–200, 2000.

    Article  PubMed  CAS  Google Scholar 

  15. McMasters KM, Turtle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL, Vennekotter DJ, Turk PS, Tate PS, Sardi A, Cerrito PB, Edwards MJ: Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used.J Clin Oncol 18:2560–2566, 2000.

    PubMed  CAS  Google Scholar 

  16. Motomura K, Inaji H, Komoike Y, Hasegawa Y, Kasugai T, Noguchi S, Koyama H: Combination technique is superior to dye alone in identification of the sentinel node in breast cancer.J Surg Oncol 76:95–99, 2001.

    Article  PubMed  CAS  Google Scholar 

  17. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R: A randomized comparison of sentinelnode biopsy with routine axillary dissection in breast cancer.N Engl J Med 349:546–553, 2003.

    Article  PubMed  Google Scholar 

  18. Steele RJ, Forrest AP, Gibson T, Stewart HJ, Chetty U: The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: a controlled randomized trial.Br J Surg 72:368–369, 1985.

    Article  PubMed  CAS  Google Scholar 

  19. Forrest AP, Everington D, McDonald CC, Steele RJ, Chetty U, Stewart HJ: The Edinburgh randomized trial of axillary sampling or clearance after mastectomy.BrJ Surg 82:1504–1508, 1995.

    Article  CAS  Google Scholar 

  20. Axelsson CK, Mouridsen HT, Zedeler K: Axillary dissection of level I and II lymph nodes is important in breast cancer classification. The Danish Breast Cancer Cooperative Group (DBCG).Eur J Cancer 28:1415–1418, 1992.

    Article  Google Scholar 

  21. NIH consensus conference: Treatment of early-stage breast cancer.JAMA 265:391–395, 1991.

    Article  Google Scholar 

  22. Macmillan RD, Barbera D, Hadjiminas DJ, Rampaul RS, Lee AH, Pinder SE, Ellis IO, Blarney RW, Geraghty JG: Sentinel node biopsy for breast cancer may have little to offer four-node-samplers. results of a prospective comparison study.Eur J Cancer 37:1076–1080, 2001.

    Article  PubMed  CAS  Google Scholar 

  23. Hansen NM, Giuliano AE: Why remove four by chance when one will suffice?Eur J Cancer 37:1067–1069, 2001.

    Article  PubMed  CAS  Google Scholar 

  24. Rutgers EJ, Nieweg OE: Finding lymph node metastases in invasive breast cancer: sampling or sentinel node procedure?Eur J Surg Oncol 28:569–570, 2002.

    Article  PubMed  CAS  Google Scholar 

  25. Chetty U: Axillary node sample to evaluate the axilla.World J Surg 25:773–779, 2001.

    Article  Google Scholar 

  26. Motomura K, Inaji H, Komoike Y, Kasugai T, Nagumo S, Hasegawa Y, Noguchi S, Koyama H: Gamma probe and ultrasonographically-guided fine-needle aspiration biopsy of sentinel lymph nodes in breast cancer patients.Eur J Surg Oncol 27:141–145, 2001.

    Article  PubMed  CAS  Google Scholar 

  27. Morrow M, Rademaker AW, Bethke KP, Talamonti MS, Dawes LG, Clauson J, Hansen N: Learning sentinel node biopsy: Results of a prospective randomized trial of two techniques.Surgery 126:714–722, 1999.

    PubMed  CAS  Google Scholar 

  28. Nieweg OE, Jansen L, Valdes Olmos RA, Rutgers EJ, Peterse JL, Hoefnagel KA, Kroon BB: Lymphatic mapping and sentinel lymph node biopsy in breast cancer.Eur J Nucl Med 26 (Suppl):S11-S16, 1999.

    Article  PubMed  CAS  Google Scholar 

  29. Derossis AM, Fey J, Yeung H, Yeh SD, Heerdt AS, Petrek J, VanZee KJ, Montgomery LL, Borgen PI, Cody HS 3rd: A trend analysis of the relative value of blue dye and isotope localization in 2,000 consecutive cases of sentinel node biopsy for breast cancer.J Am Coll Surg 193:473–478, 2001.

    Article  PubMed  CAS  Google Scholar 

  30. Motomura K, Noguchi A, Hashizume T, Hasegawa Y, Komoike Y, Inaji H, Saida T, Koyama H: Usefulness of a solid-state gamma camera for sentinel node identification in patients with breast cancer. Submitted.

  31. Flett MM, Going JJ, Stanton PD, Cooke TG: Sentinel node localization in patients with breast cancer.Br J Cancer 85:991–993, 1998.

    CAS  Google Scholar 

  32. Weiser MR, Montgomery LL, Susnik B, Tan LK, Borgen PI, Cody HS: Is routine intraoperative frozen-section examination of sentinel lymph nodes in breast cancer worthwhile?Ann Surg Oncol 7:651–655, 2000.

    Article  PubMed  CAS  Google Scholar 

  33. Veronesi U, Paganelli G, Viale G, Galimberti V, Luini A, Zurrida S, Robertson C, Sacchini V, Veronesi P, Orvieto E, De Cicco C, Intra M, Tosi G, Scarpa D: Sentinel lymph node biopsy and axillary dissection in breast cancer: Results in a large series.J Natl Cancer Inst 91:363–373, 1999.

    Google Scholar 

  34. Rubio IT, Korourian S, Cowan C, Krag DN, Colvert M, Klimberg VS: Use of touch preps for intraoperative diagnosis of sentinel lymph node metastases in breast cancer.Ann Surg Oncol 5:689–694, 1998.

    Article  PubMed  CAS  Google Scholar 

  35. Ratanawichitrasin A, Biscotti CV, Levy L, Crowe JP: Touch imprint cytological analysis of sentinel lymph nodes for detecting axillary metastases in patients with breast cancer.Br J Surg 86:1346–1348, 1999.

    Article  PubMed  CAS  Google Scholar 

  36. vanDiest PJ, Torrenga H, Borgstein PJ, Pijpers R, Bleichrodt RP, Rahusen FD, Meijer S: Reliability of intraoperative frozen section and imprint cytological investigation of sentinel lymph nodes in breast cancer.Histopathology 35:14–18, 1999.

    Article  PubMed  Google Scholar 

  37. Henry-Tillman RS, Korourian S, Rubio IT, Johnson AT, Mancino AT, Massol N, Smith LF, Westbrook KC, Klimberg VS: Intraoperative touch preparation for sentinel lymph node biopsy: A 4-year experience.Ann Surg Oncol 9:333–339, 2002.

    Article  PubMed  Google Scholar 

  38. Motomura K, Inaji H, Komoike Y, Kasugai T, Nagumo S, Noguchi S, Koyama H: Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery.Br J Surg 87:597–601, 2000.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazuyoshi Motomura.

About this article

Cite this article

Motomura, K., Komoike, Y., Nagumo, S. et al. Controversies in sentinel node biopsy for breast cancer. Breast Cancer 11, 20–26 (2004). https://doi.org/10.1007/BF02967996

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02967996

Key words

Navigation