Should
sentinel node biopsies be done outside a clinical trial setting?
Interview
with Neil Love, MD from Breast Cancer Update for Surgeons,
Program 1 2000
Play
Audio Below:
Dr. Love: So, I take it from your three point approach that you
just made, what’s the inference in terms of sentinel node outside
of a clinical trial?
Dr.
Krag: Well, the inference is that we don’t have data to justify
that approach in patients. That’s not to say it’s not
logical. I mean, that’s the whole purpose of doing this study
and using this technique is to eliminate axillary dissection in
as many patients as we can.
Dr.
Love: So, are you saying that sentinel node should not be done at
this time outside of the clinical trial?
Dr.
Krag: I’ve personally never done a sentinel node in a breast
case outside of this clinical trial.
Dr.
Love: Are you saying then that, for example, a surgeon or practice
who is not part of the NASPB or is not going to be involved within
some other study, should not be doing sentinel node?
Dr.
Krag: Well, I’m not going to say that because I think you know
there is a judgement call in all cases. For instance, if somebody
has got a very small tumor, the odds for them to have metastases
are relatively low. If their decision is to do chemotherapy anyway,
you know, what’s the potential? If you really crank up in numbers
it’s a very small potential benefit in this select group. And
there’s people that have advocated not doing any axillary dissection.
So I think that people can use their judgment, but in terms of making
the claim that this is as good, we’re done now, we’ve
got it, this is as good as axillary dissection, that’s a fallacy
because we don’t have that data. Even though I expect and hope
that it will, we don’t have data. So as we are now getting
into the era of evidence-based criterion, categorize our data, we
don’t have this for sentinel node.
Is
routine intraoperative frozen-section examination of sentinel lymph
nodes in breast cancer worthwhile Weiser, M. R.; Montgomery,
L. L.; Susnik, B.; Tan, L. K.; Borgen, P. I., and Cody, H. S.? Annals
of Surgical Oncology. 7(9):651-655, 2000 Oct. In progress
Micrometastatic
nodal disease in breast cancer - The dilemma continues. Rose,
M. D. and Giuliano, A. E. (Reprint available from: Giuliano
AE St Johns Hlth Ctr, John Wayne Canc Inst 2200 Santa Monica Blvd
Santa Monica, CA 90404 USA). Journal of Surgical Oncology. 74(2):87-89,
2000 Jun. No abstract
Variation
in axillary node dissection influences the degree of nodal involvement
in breast cancer patients.
Saha, S.; Farrar, W. B.; Young, D. C.; Ferrara, J. J., and Burak,
W. E.. Journal of Surgical Oncology. 73(3):134-137, 2000 Mar.
A
multicenter validation study of sentinel lymph node biopsy by the
Japanese Breast Cancer Society.
Noguchi, M.; Motomura, K.; Imoto, S.; Miyauchi, M.; Sato, K.; Iwata,
H.; Ohta, M.; Kurosumi,
M., and Tsugawa, K. (Reprint available from: Noguchi M Kanazawa
Univ Hosp, Operat Ctr Takara Machi 13-1 Kanazawa Ishikawa 9208641
Japan).. Breast Cancer Research & Treatment. 63(1):31-40, 2000
Sep. In process
Sentinel-node
biopsy sampling in breast cancer. Nieweg, O. E.; Tanis, P. J.; Olmos, R. A. V.; Rutgers, E. J.
T., and Kroon, B. B. R. (Reprint available from: Nieweg OE Netherlands
Canc Inst, Antoni Van Leeuwenhoek Hosp, Dept Surg Plesmanlaan 121
NL-1066 CX Amsterdam Netherlands).. Lancet. 356(9243): 1770, 2000
Nov 18. In process
Increased
false negative sentinel node biopsy rates after preoperative chemotherapy
for invasive breast carcinoma Nason,
K. S.; Anderson, B. O.; Byrd, D. R.; Dunnwald, L. K.; Eary, J. F.;
Mankoff, D. A.; Livingston, R.; Schmidt, R. A.; Jewell, K. D.; Yeung,
R. S., and Moe, R. E.. Cancer. 89(11):2187-2194, 2000 Dec 1. In
process
Pathologic
analysis of sentinel lymph nodes in breast carcinoma. Liberman,
L. (Reprint available from: Liberman L Mem Sloan Kettering Canc
Ctr, Dept Radiol, Breast Imaging Sect 1275 York Ave New York, NY
10021 USA). Cancer. 88(5):971-977, 2000 Mar 1. No abstract
Long-term
morbidity following axillary dissection in breast cancer patients
- clinical assessment, significance for life quality and the impact
of demographic, oncologic and therapeutic factors. Kuehn,
T.; Klauss, W.; Darsow, M.; Regele, S.; Flock, F.; Maiterth, C.;
Dahlbender, R.; Wendt, I., and Kreienberg, R. Breast Cancer Research
& Treatment. 64(3):275-286, 2000 Dec.
Sentinel
lymph node biopsy: Is it indicated in patients with high-risk ductal
carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey,
J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek,
J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology.
7(9):636-642, 2000 Oct. In process
Pilot
study on sentinel node biopsy in breast cancer - Commentary Greene, F. L. (Reprint available from: Greene FL Carolinas Med
Ctr, Dept Gen Surg Charlotte, NC 28203 USA).. Journal of Surgical
Oncology. 73(3):133, 2000 Mar.
Impact
of sentinel lymph node mapping on relative charge in patients with
early-stage breast cancer. Gemignani, M. L.; Cody, H. S.; Fey, J. V.; Tran, K. N.; Venkatraman,
E., and Borgen, P. I. Annals of Surgical Oncology. 7(8):575-580,
2000 Sep. In process
Does
sentinel lymphadenectomy improve staging and alter therapy in elderly
women with breast cancer? DiFronzo, L. A.; Hansen, N. M.; Stern, S. L.; Brennan, M. B.,
and Giuliano, A. E. Annals of Surgical Oncology. 7(6):406-410, 2000
Jul. In process
A
high number of tumor free axillary lymph nodes from patients with
lymph node negative breast is associated with poor outcome. Cody, H. S. and Van Zee, K. J. (Reprint available from: Cody
HS Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol 1275 York Ave
New York, NY 10021 USA).. Cancer. 89(1):218, 2000 Jul 1. No abstract
Challenging
the myth of exercise-induced lymphedema following breast cancer:
A series of case reports — Commentary.
(Reprint available from: Cady B Brown Univ, Women & Infants
Hosp, Breast Hlth Ctr Providence, RI 02908 USA).. Journal of Surgical
Oncology. 74(2):98-99, 2000 Jun. No abstract
Should
irradiation replace dissection for patients with breast cancer with
clinically negative axillary lymph nodes? Recht, A. (Reprint available from: Recht A Beth Israel Deaconess
Med Ctr, Dept Radiat Oncol East Campus,Finard Bldg B25,330 Brookline
Ave Boston, MA 02215 USA). Journal of Surgical Oncology. 72(4):184-192,
1999 Dec. No abstract
Lymphedema:
Current issues in research and management. Petrek,
J. A.; Pressman, P. I., and Smith, R. A. Ca: a Cancer Journal for
Clinicians. 50(5):292-307, 2000 Sep-Oct.
