Wednesday, 25 May 2011
Sentinel Lymph Node Biopsy. Is it useful?
I have recently read an article that caught my eye and somewhat relates to skin pathology.
The article was entitled ‘Axillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and Sentinel Node Metastasis’ and was in the February 9th, 2011 issue of the Journal of the American Medical Association. Although this relates to patients with breast cancer I wonder if there will be any overflow of this argument into the ongoing debate over the use of sentinel lymph node biopsy (SLNB) with regards to patients with melanoma.
The results of the aforementioned study showed “among patients with limited sentinel lymph node (SLN) metastatic breast cancer treated with breast conservation and systemic therapy, the use of SLND (sentinel lymph node dissection) alone compared with ALND (axillary lymph node dissection) did not result in inferior survival.” This result has also been mirrored in multiple melanoma SLNB studies. Many people have and still continue to argue over the pros (eg. without a SLNB it is not possible to accurately stage melanoma according to international guidelines) and cons (eg. the impact of complete lymph node dissection (CLND) on a patient’s immune capability).
I wonder if in the future SLNB will remain standard practice or if it was a good idea at the time.
Many thanks for reading and hopefully this post will get some interesting comments and I am sure it will.
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www.skinpathonline.com (will be up in the near future)
PS. This is the link for the JAMA article (http://jama.ama-assn.org/content/305/6/569.abstract)