J.Jpn. Surg. Soc.. 104(11): 773-777, 2003

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Feature topic

CURRENT ISSUES IN SENTINEL NODE NAVIGATION SURGERY IN BREAST CANCER

Sentinel node navigation surgery (SNNS) will become a standard surgical technique to avoid unnecessary axillary lymph node dissection (ALND) in node-negative breast cancer patients. Numerous studies on SNNS have confirmed and demonstrated the reliability of the hypothesis of sentinel lymph nodes in the last decade. In Japan, several feasibility studies on SNNS started in the mid-1990s. Japanese investigators have attempted to perform SNNS using dyes and radiopharmaceuticals. Their results were similar to those reported in Western countries. Now several randomized, phase III trials are underway to assess SNNS in breast cancer in comparison with ALND. On the other hand, observational studies are carried out lf sentinel lymph nodes are confirmed to be histologically negative. However, many issues regarding this rninimally invasive surgery remain unsolved in Japan: health insurance coverage; guidelines for SNNS; and safe handling of radioactive breast tissues and lymph node specimens. The current status and problems of SNNS in breast cancer are reported.

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