Premature adoption of sentinel node biopsy as standard test is a concern.

2003 NOV 6 - (NewsRx.com & NewsRx.net) -- A new study suggests that surgeons are routinely performing an investigational procedure called sentinel node biopsy (SNB) on women with early-stage breast cancer and this may be affecting the accrual and generalizability of ongoing trials of the procedure, researchers say.

The findings appeared in the October 15, 2003, issue of the Journal of the National Cancer Institute.

SNB is used to check the one or more lymph nodes at greatest risk for breast cancer metastases. The procedure is considered a potential alternative to standard axillary node dissection (AND), which involves removing all of the lymph nodes in the armpit area and has been associated with chronic problems such as lymphedema (arm swelling caused by the blockage of lymph flow).

Large trials are under way to examine the safety and accuracy of SNB. However, the procedure is already gaining popularity, and there is concern that premature adoption of SNB as standard care may compromise these ongoing trials.

To examine patterns of SNB use in academic comprehensive cancer centers, Stephen B. Edge, MD, of the Roswell Park Cancer Institute in Buffalo, New York, and his colleagues from the National Comprehensive Cancer Network looked at 3,003 women with stage I or stage II breast cancer who underwent SNB alone, SNB followed by AND, AND alone, or no axillary surgery at one of five comprehensive cancer centers between 1997 and 2000, which encompasses the period SNB was entering clinical practice in the United States.

Use of SNB alone was associated with breast-conserving surgery. During the study period, use of SNB alone increased over time, from 8% in ...