[Prognostic benefits evaluated: new guidelines for systemic adjuvant therapy for axillary node-negative breast cancer...

The new guidelines for adjuvant systemic therapy in patients with resectable breast cancer adopted by the Dutch National Breast Cancer Platform (NABON) and the Dutch Society for Medical Oncology (NVMO) have as a prerequisite that adjuvant treatment must increase the expected absolute number of patients with 10-year survival by 5% or more. It is therefore apparently considered justifiable to treat 20 patients in order to obtain 10-year survival for one extra of these. This view appears to be in contrast to the view held by adversaries of implementation of the sentinel node biopsy procedure who consider it justifiable to submit 650 patients to a mutilating complete axillary lymph node dissection for disease-staging purposes in order to gain only one extra patient with a 10-year survival.