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JNCI Journal of the National Cancer Institute 2003 95(20):1498-1499; doi:10.1093/jnci/djg096
© 2003 by Oxford University Press
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© 2003 Oxford University Press

EDITORIAL

Practice Patterns of Sentinel Node Biopsy at Five Comprehensive Cancer Centers

David N. Krag, Thomas B. Julian

Affiliations of authors: D. N. Krag, Department of Surgery, College of Medicine, University of Vermont, Burlington; T. B. Julian, Department of Human Oncology, Allegheny General Hospital, Drexel University School of Medicine, Pittsburgh, PA.

Correspondence to: David N. Krag, MD, College of Medicine, University of Vermont, Given Bldg., Rm. E309, Burlington, VT 05405 (e-mail: david.krag@uvm.edu).

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Data from six prospective randomized trials are available in which axillary node dissection (AND) was compared with observation as initial treatment for invasive breast cancer. It is noteworthy that all of these trials reported an observed survival that was higher in the group that initially had AND. The overall survival increase reported in the AND group ranged from 4% to 18% (1–6). Analysis of the combined data from all six trials, which included more than 2400 cases, resulted in a statistically significant survival advantage associated with AND of 5.4% (95% confidence interval [CI] = 2.7% to 8.0%) (7). These randomized trials of AND versus observation may be considered out-of-date; however, the data from these trials have not been challenged by modern, prospective randomized clinical . . . [Full Text of this Article]


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