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Recommendation
Sentinel node biopsy – Indications #1
Offer sentinel node biopsy to breast cancer patients with no clinical or radiological evidence of axillary lymph node metastases at initial diagnosis.
Patients with operable (invasive) breast cancer with no clinical or radiological evidence of axillary lymph node metastases at initial diagnosis should be offered sentinel node biopsy
SLNB, rather than full nodal clearance, is the standard of care for axillary staging in early, clinically-node negative breast cancer (Level of evidence – II)
Perform minimal surgery, rather than lymph node clearance, to stage the axilla for people with invasive breast cancer and no evidence of lymph node involvement on ultrasound or a negative ultrasound‑guided needle biopsy. Sentinel lymph node biopsy (SLNB) is the preferred technique.
At least one meta-analysis, systematic review, or RCT rated as 1++, and directly applicable to the target population; or A body of evidence consisting principally of studies rated a 1+, directly applicable to the target population, and demonstrating overall consistency of results
Strong evidence for efficacy with a substantial clinical benefit, strongly recommended
How this guidance was developed
This recommendation was adopted from the NCCP 2015 guidelines (Ireland). The source recommendation was based on a systematic review of the evidence conducted to September 2014 and was graded ‘A’ (using SIGN methods) by the source guideline authors. The source recommendation was accepted with minor stylistic changes, but with no changes to the meaning or tone of the source recommendation.
This recommendation aligns with a more recent source recommendation in ESMO (2019) early breast cancer clinical practice guidelines which indicates that ‘SLNB, rather than full nodal clearance, is the standard of care for axillary staging in early, clinically-node negative breast cancer ('A')'.
This aligns with the NICE (2009) guidance on this topic based on a systematic review of the evidence (not updated in 2018) which indicates that SNB is the preferred technique in patients with no evidence of lymph node involvement on ultrasound or a negative ultrasound-guided needle biopsy.
Sentinel node biopsy – Indications #1
Recommendation
Offer sentinel node biopsy to breast cancer patients with no clinical or radiological evidence of axillary lymph node metastases at initial diagnosis.
Principles in action
Safe and quality care
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Communication
This recommendation was adopted from the NCCP 2015 guidelines (Ireland). The source recommendation was based on a systematic review of the evidence conducted to September 2014 and was graded ‘A’ (using SIGN methods) by the source guideline authors. The source recommendation was accepted with minor stylistic changes, but with no changes to the meaning or tone of the source recommendation.
This recommendation aligns with a more recent source recommendation in ESMO (2019) early breast cancer clinical practice guidelines which indicates that ‘SLNB, rather than full nodal clearance, is the standard of care for axillary staging in early, clinically-node negative breast cancer ('A')'.
This aligns with the NICE (2009) guidance on this topic based on a systematic review of the evidence (not updated in 2018) which indicates that SNB is the preferred technique in patients with no evidence of lymph node involvement on ultrasound or a negative ultrasound-guided needle biopsy.