Racial Disparities in Adoption of Axillary Sentinel Lymph Node Biopsy and Lymphedema Risk in Women With Breast Cancer

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Abstract
Sentinel lymph node biopsy (SLNB) was developed to prevent major complications associated with axillary lymph node dissection (ALND) for surgical staging of clinically node-negative breast cancer. Several multicenter studies and randomized trials1-5 have demonstrated that SLNB is an acceptable alternative for axillary staging and is associated with decreased complications and no significant differences in regional recurrence risk or survival compared with ALND. In 1998, the American Society of Breast Surgeons6 released its first guidelines for surgeons to appropriately incorporate the SLNB technique into their practice. In the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer, version 1.2002, the NCCN panel and the American Society of Breast Surgeons recommended SLNB as an alternative to ALND in selected patients with clinically node-negative, clinical stage I breast cancer.7,8 Sentinel lymph node biopsy was then endorsed by other national and international consensus groups including the St. Gallen International Consensus Panel in 20039 and the American Society of Clinical Oncology in 2005.10 In the NCCN Guidelines for Breast Cancer, version 1.2007,11 the NCCN panel endorsed SLNB as the preferred axillary staging procedure in patients with clinically node-negative breast cancer.

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