It has always been disappointing
to receive a histology report after an axillary dissection (ALND) saying that the
only positive lymph node was the sentinel lymph node (SLN). It is for this reason
that there have been many efforts to create the best predictive model in order to
avoid non sentinel node dissection and in fact there are in use many of them with
a reasonable success rate. The publication of the multicenter study by Giuliano et al. showed a disease free survival
and overall survival rate equal between patients with positive SLN with or without
axillary dissection in a large group of patients. Breast surgeons around the world
have long before been interested in reducing even more the need for axillary lymph
node dissection, so they easily grasped the chance of those results and applied
them in their practice. Objections have been expressed regarding the integrity of
the study methods and the results which make the need for a second study to confirm
those results absolutely necessary.
Cite this paper
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