Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Sentinel-lymph-node biopsy (SLNB) is crucial for staging breast cancer and guiding treatment decisions.
• Previous trials demonstrated SLNB's accuracy in detecting axillary lymph node metastasis for small tumors.
• This study updates previous findings with extended follow-up data.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of SLNB in breast cancer patients.
• To compare outcomes between immediate axillary-lymph-node dissection (ALND) and selective ALND based on SLNB results.
• To assess the impact of SLNB on disease-free survival and overall survival.

Main Methods:

• Randomized trial involving women with breast tumors ≤ 2 cm.
• Patients were assigned to either immediate ALND or SLNB with selective ALND.
• Endpoints included axillary metastasis rates, SLNB staging accuracy, and survival rates.

Main Results:

• False-negative SLNB rates were low in both groups.
• Only one case of overt axillary metastasis occurred in the selective ALND group.
• Disease-free and overall survival rates were comparable between the groups after a median follow-up of 79 months.

Conclusions:

• SLNB allows avoidance of total ALND in patients with negative sentinel nodes, reducing morbidity and costs.
• The low rate of axillary metastasis in the selective ALND group supports its safety.
• SLNB is a reliable staging tool in breast cancer management.