J.Jpn. Surg. Soc.. 101(3): 311-314, 2000

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Feature topic

SENTINEL NODE NAVIGATION SURGERY IN BREAST CANCER

Sentinel node navigation surgery (SNNS) is a promising surgical technique to avoid unnecessary axillary lymph node dissection (ALND) in breast cancer. There are various choices regarding the site of injection of the vital blue dye or radiopharmaceuticals, the dose of radioactivity used, the interval between dye injection or lymphoscintiscan and SNNS, and various surgical procedures for SNNS in breast cancer. However, many investigators have reported that SNNS is feasible and reliable in histologically sentinel node-negative breast cancer. In our hospital, SNNS with indigocarmine began in January 1998. After a feasibility study of SNNS in 200 cases of early breast cancer, practical SNNS is being performed using indigocarmine and double-tracer technetium-99m-human serum albumin and technetium-99m-tin colloid. As of January 2000, the identification rate of sentinel lymph nodes was 97% and ALND was omitted in 57 (63%) of 90 cases examined. Clinical outcome, arm morbidity, and cost benefits should be evaluated in a randomized trial comparing SNNS to ALND. Nevertheless, SNNS in breast cancer will be necessary for surgical oncologists in the near future.

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