Sentinel-lymph-node biopsy for breast cancer - Not yet the standard of care

Sentinel-lymph-node biopsy has the potential to raise the level of sophistication and accuracy of breast-cancer staging. Before axillary dissection is abandoned in favor of this new technique, however, it is important to determine the false negative rate of sentinel-lymph-node biopsy in large multicenter studies; characterize the patients with false negative sentinel-lymph-node results to determine whether some patients are not appropriate candidates for the procedure; obtain a consensus on what false negative rates are acceptable in specific groups of patients with breast cancer; and optimize and standardize the surgical, nuclear-medicine, and pathological aspects of the procedure. These goals can be achieved only through large, multi-institutional efforts. Fortunately, several multi- institutional studies are currently under way, and any surgeon who wishes to perform sentinel-lymph-node biopsy should be able to participate in one or more studies. In addition, prospective, randomized trials are in the planning stages. Until this work is completed, sentinel-lymph-node biopsy for breast cancer cannot be accepted as the standard of care.