PURPOSE: To develop a guideline for the use of sentinel node biopsy (SNB) in early stage breast cancer. METHODS: An American Society of Clinical Oncology (ASCO) Expert Panel conducted a systematic review of the literature available through February 2004 on the use of SNB in early-stage breast cancer. The panel developed a guideline for clinicians and patients regarding the appropriate use of a sentinel lymph node identification and sampling procedure from hereon referred to as SNB. The guideline was reviewed by selected experts in the field and the ASCO Health Services Committee and was approved by the ASCO Board of Directors. RESULTS: The literature review identified one published prospective randomized controlled trial in which SNB was compared with axillary lymph node dissection (ALND), four limited meta-analyses, and 69 published single-institution and multicenter trials in which the test performance of SNB was evaluated with respect to the results of ALND (completion axillary dissection). There are currently no data on the effect of SLN biopsy on long-term survival of patients with breast cancer. However, a review of the available evidence demonstrates that, when performed by experienced clinicians, SNB appears to be a safe and acceptably accurate method for identifying early-stage breast cancer without involvement of the axillary lymph nodes. CONCLUSION: SNB is an appropriate initial alternative to routine staging ALND for patients with early-stage breast cancer with clinically negative axillary nodes. Completion ALND remains standard treatment for patients with axillary metastases identified on SNB. Appropriately identified patients with negative results of SNB, when done under the direction of an experienced surgeon, need not have completion ALND. Isolated cancer cells detected by pathologic examination of the SLN with use of specialized techniques are currently of unknown clinical significance. Although such specialized techniques are often used, they are not a required part of SLN evaluation for breast cancer at this time. Data suggest that SNB is associated with less morbidity than ALND, but the comparative effects of these two approaches on tumor recurrence or patient survival are unknown.
PURPOSE: To develop a guideline for the use of sentinel node biopsy (SNB) in early stage breast cancer. METHODS: An American Society of Clinical Oncology (ASCO) Expert Panel conducted a systematic review of the literature available through February 2004 on the use of SNB in early-stage breast cancer. The panel developed a guideline for clinicians and patients regarding the appropriate use of a sentinel lymph node identification and sampling procedure from hereon referred to as SNB. The guideline was reviewed by selected experts in the field and the ASCO Health Services Committee and was approved by the ASCO Board of Directors. RESULTS: The literature review identified one published prospective randomized controlled trial in which SNB was compared with axillary lymph node dissection (ALND), four limited meta-analyses, and 69 published single-institution and multicenter trials in which the test performance of SNB was evaluated with respect to the results of ALND (completion axillary dissection). There are currently no data on the effect of SLN biopsy on long-term survival of patients with breast cancer. However, a review of the available evidence demonstrates that, when performed by experienced clinicians, SNB appears to be a safe and acceptably accurate method for identifying early-stage breast cancer without involvement of the axillary lymph nodes. CONCLUSION: SNB is an appropriate initial alternative to routine staging ALND for patients with early-stage breast cancer with clinically negative axillary nodes. Completion ALND remains standard treatment for patients with axillary metastases identified on SNB. Appropriately identified patients with negative results of SNB, when done under the direction of an experienced surgeon, need not have completion ALND. Isolated cancer cells detected by pathologic examination of the SLN with use of specialized techniques are currently of unknown clinical significance. Although such specialized techniques are often used, they are not a required part of SLN evaluation for breast cancer at this time. Data suggest that SNB is associated with less morbidity than ALND, but the comparative effects of these two approaches on tumor recurrence or patient survival are unknown.
Authors: Anton Haid; Thorsten Kühn; Amit Goyal; Christoph Tausch; Florentina Peintinger; Peter Schrenk; Hans Gallowitsch Journal: Breast Care (Basel) Date: 2009-06-17 Impact factor: 2.860
Authors: Martin R Austwick; Benjamin Clark; Charles A Mosse; Kristie Johnson; D Wayne Chicken; Santosh K Somasundaram; Katherine W Calabro; Ying Zhu; Mary Falzon; Gabrijela Kocjan; Tom Fearn; Stephen G Bown; Irving J Bigio; Mohammed R S Keshtgar Journal: J Biomed Opt Date: 2010 Jul-Aug Impact factor: 3.170
Authors: Claire M B Holloway; Alexandra Easson; Jaime Escallon; Wey Liang Leong; May Lynn Quan; Michael Reedjik; Frances C Wright; David R McCready Journal: Can J Surg Date: 2010-08 Impact factor: 2.089
Authors: Robert W Holloway; Nadeem R Abu-Rustum; Floor J Backes; John F Boggess; Walter H Gotlieb; W Jeffrey Lowery; Emma C Rossi; Edward J Tanner; Rebecca J Wolsky Journal: Gynecol Oncol Date: 2017-05-28 Impact factor: 5.482
Authors: Elizabeth A Mittendorf; Karla V Ballman; Linda M McCall; Min Yi; Aysegul A Sahin; Isabelle Bedrosian; Nora Hansen; Sheryl Gabram; Thelma Hurd; Armando E Giuliano; Kelly K Hunt Journal: J Clin Oncol Date: 2014-12-08 Impact factor: 44.544