Current status of sentinel node adenectomy and future perspectives

Sentinel node adenectomy has rapidly been accepted in recent years. A survey performed under the auspices of the Japanese Breast Cancer Society revealed that about 40% of institutions in Japan have already introduced sentinel lymph adenectomy. Analysis of questionnaire responses from 40 institutions in Japan revealed an identification rate using the dye method alone of 87% compared with 96% using the combined method. The identification rate and the false-negative rate are about the same among various methods used such as colloidal radiotracers, injection site, use of lymphoscintigraphy, etc., provided that the surgeon has adequate experience. It is recommended that the surgeon should start to perform sentinel node adenectomy after experiencing more than 60 cases, because there is a learning curve. Some investigators are devising other methods to replace the RI method, for example, using magnetic particles instead of RI colloid and detecting them using magnetic probes. and a trial to detect lymphatic flow with CT after local injection of contrast medium is also being conducted. Sentinel node adenectomy may become a standard technique for early breast cancer patients in the near future.