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Sentinel Lymph Node Biopsy Versus Axillary Treatment

Sentinel lymph node biopsy in women with operable breast cancer is used routinely in some countries for staging of the axilla despite limited data on morbidity and mortality outcomes. Mansel et al. (p. 599 ) conducted a multicenter randomized trial in patients with clinically node-negative invasive breast cancer to compare arm and shoulder morbidity and quality of life between those who received sentinel lymph node biopsy and those who received standard axillary treatment. In intention-to-treat analyses, the sentinel lymph node biopsy group experienced less lymphedema and sensory loss at 12 months than the standard axillary treatment group. The sentinel lymph node biopsy group had lower drain usage, shorter hospital stays and time to resumption of normal activities after surgery, and better overall patient-recorded quality of life and objective measures of arm function than the standard treatment group. The authors conclude that sentinel lymph node biopsy should be the treatment of choice for early-stage breast cancer patients with clinically negative nodes.