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| |  Technique Eliminates Need For Extensive Lymph Node Dissections In Early Stage Breast Cancer NEW YORK, N.Y. -- April 6, 1999 -- Sentinel node biopsy, a surgical biopsy technique that can predict whether cancer has spread into the surrounding lymph nodes, has proven to be an accurate diagnostic tool for early stage breast cancer, according to a study by Memorial Sloan-Kettering Cancer Center breast surgeons. Their work was published in the April 1999 Annals of Surgery. A report of the first 500 cases performed at Memorial Sloan-Kettering from October 1996 to May 1998 confirmed that breast cancer patients with small tumors between one and five centimeters could avoid unnecessary surgery to remove axillary lymph nodes if the sentinel node biopsy is negative. Since eighty percent of patients with earliest stage breast cancer have no lymph node involvement, this technique will spare an estimated 60,000 to 80,000 patients each year from undergoing the procedure that has previously been an accepted part of standard treatment. "This study is the largest published institutional experience," said Dr. Patrick Borgen, Chief of breast service at Memorial Sloan-Kettering and co-author of the study. "Our data add to a growing body of research confirming that sentinel node biopsy is very effective in predicting the spread of breast cancer. We believe that lumpectomy and sentinel node biopsy should become standard treatment for patients with small, localized tumors." Researchers have confirmed the hypothesis that the lymphatic drainage of breast cancer can be identified and traced to the first draining lymph node. This node accurately predicts the status of the entire axilla. If the sentinel node is negative, as it was in eight-three percent of the patients in the Memorial Sloan-Kettering study, then the remainder of the lymph nodes in the axilla will also be cancer free and no further surgery is necessary. Memorial Sloan-Kettering surgeons advocate a combined approach to detect the sentinel node. Dr. Charles Cox, et al, developed this method at the H. Lee Moffit Cancer Center in Tampa, Fla., which provides two means of identification. In the MSK study, the sentinel node was located by blue dye only in nine percent of the patients, by isotope only in fourteen percent of the patients, and by both methods in seventy-seven percent of the patients. "We found that the combination of blue dye and isotope allowed for the greatest accuracy in locating the sentinel node and we recommend this combined approach," said Dr. Hiram Cody III, a breast surgeon at Memorial Sloan-Kettering and a co-author of the paper. "The success in locating the sentinel node was unrelated to tumor size, tumor type, tumor location, or previous biopsy." The benefits of the sentinel node biopsy for node-negative patients are extensive. The procedure is performed on an outpatient basis using a local anesthetic. The patient can go home that day with just a small incision and usually return to work in two days. By comparison, patients who have standard axillary node dissection require general anesthesia, a hospital stay, and face a lengthy recovery. Ten to twenty percent of these patients will develop lymphedema at some time after the surgery, a swelling of the arm that can be painful and debilitating.
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