At first glance, sentinel node biopsy appears invitingly easy, but success in completing the sometimes technically difficult procedures involved will define the oncological relevance of the technique. While Kollias et al conclude that sentinel node biopsy is an accurate method of assessing axillary lymph node status, the accuracy has varied in other series. A possible explanation is the different techniques used in individual series. In Australia, we have a window of opportunity to work towards a standardised approach to sentinel node biopsy, using agreed protocols and prospective and uniform data collection. Kollias and colleagues , and other representatives from the major breast units and the Section of Breast Surgery of the Royal Australasian College of Surgeons, are working together and have proposed an Australasian prospective randomised trial with the capacity to involve all surgeons who are interested in breast cancer management.
New techniques require proper evaluation.
As a group, surgeons have been quick to adopt new procedures before scientific validation. In addition, consumer pressures, and sometimes market pressures, are at work. For comparison, consider laparoscopic cholecystectomy, which has now gained widespread approval. There is no doubt that, in those early days, considerable morbidity for many patients could have been avoided with more caution and less haste. It therefore behoves us to ensure that, with any new procedure, consumers are not placed at increased risk, particularly if it is performed with limited expertise.