Use of sentinel lymph node biopsy now common in breast ca patients aged 70 and older. (Data From Five U.S. Cancer Centers).

HOLLYWOOD, FLA. -- Sentinel lymph node biopsy is becoming standard care for women with early-stage breast cancer as the number of axillary node dissections continues to decrease, according to a comprehensive, multicenter study.

"The real dramatic difference was seen in most women 70 and older," Dr. Stephen B. Edge said at the annual conference of the National Comprehensive Cancer Network.

When the NCCN breast cancer database was established in 1997, it was predominantly women aged 50-60 who were having sentinel lymph node biopsy (SLNB) alone for stage I breast cancer. Data from the second half of 2000 show a 40%-50% decrease in axillary node dissections in women over age 70, compared with 1997; more than 70% had SLNB alone.

"So availability of a less invasive procedure has dramatically changed our practice," he said.

Researchers evaluated 3,587 women with stage I or II breast cancer at five leading cancer centers nationwide to quantify and track axillary node dissection and/or SLNB. Of the participants, 54% had stage I disease, 30% had stage IIA cancer, and 16% had stage IIB cancer.

SLNB alone was used more commonly in participants with small tumors; 74% of the women had tumors smaller than 2 cm, and 26% had tumors between 2 cm and 5 cm. The approach was used exclusively in the 2,164 women opting for breast-conserving surgery; the remaining 1,423 women opted for a mastectomy. SLNB alone was used in 29% of patients with stage I breast cancer, 13% of patients with stage IIA, and 3% of patients with stage IIB.

The five participating institutions in this ongoing data collection are Dana-Farber Cancer Institute, City of Hope Cancer Center, Fox Chase Cancer Center, M.D. Anderson Cancer Center, and Roswell Park Cancer Institute in Buffalo, N.Y., where Dr. Edge is chief of the breast division and interim chair of the department of surgery.