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March 12, 1997

Lymphatic Mapping and Sentinel Node Biopsy in Breast Cancer-Reply

Author Affiliations

University of South Florida Tampa

JAMA. 1997;277(10):791-792. doi:10.1001/jama.1997.03540340025025

In Reply.  —We recognize and applaud the original description and subsequent contributions of lymphatic mapping for both melanoma and breast cancer made by Dr Giuliano and colleagues. In their original report of the new technology,1 Giuliano et al describe a success rate for identifying the sentinel lymph node of 65.5% (114 of 174 cases) using a blue dye-only technique. We would argue that if the learning curve for any new technique is so steep that after 174 cases a success rate of only 65.5% is obtained, it is unlikely that the new technology will be incorporated into the everyday practice of the surgeon. Thus, the technique had to be improved. The true test of any technology is whether others can replicate the results and incorporate the procedure into their practice.We have now performed more than 200 mappings for breast cancer and have been unable to duplicate the data on mapping