The lancet oncology
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The lancet oncology · Dec 2006
Randomized Controlled TrialSentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study.
In women with breast cancer, sentinel-lymph-node biopsy (SLNB) provides information that allows surgeons to avoid axillary-lymph-node dissection (ALND) if the SLN does not have metastasis, and has a favourable effect on quality of life. Results of our previous trial showed that SLNB accurately screens the ALN for metastasis in breast cancers of diameter 2 mm or less. We aimed to update this trial with results from longer follow-up. ⋯ SLNB can allow total ALND to be avoided in patients with negative SLNs, while reducing postoperative morbidity and the costs of hospital stay. The finding that only one overt axillary metastasis occurred during follow-up of patients who did not receive ALND (whereas eight cases were expected) could be explained by various hypotheses, including those from cancer-stem-cell research.
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The lancet oncology · Dec 2006
ReviewImmunobiology of the sentinel lymph node and its potential role for antitumour immunity.
The sentinel lymph node (SLN) is thought to be an important lymphoid organ for protecting against metastasis and is thought to play a crucial part in provoking antitumour immunity. Because SLN biopsy is undertaken for various types of cancers, such as malignant melanoma and breast cancer, SLN mapping has become a standard procedure, thereby eliminating unnecessary lymph-node resection in patients who do not have affected nodes. ⋯ Furthermore, cell death after primary systemic chemotherapy for solid tumours can provoke an antigen-specific immunity in the tumour, which affects tumour response to treatment and, therefore, survival in patients. This review discusses the immunobiology of the SLN and potential strategies for activation of antitumour immunity by primary systemic chemotherapy and other modalities, in terms of tumour-size reduction and survival benefit.
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The lancet oncology · Dec 2006
Biography Historical ArticleMargaret Chan named as new Director-General of WHO.