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Practice Point
Sentinel node biopsy – Pregnant women
In pregnant women with breast cancer with no clinical or radiological evidence of axillary lymph node metastases at initial diagnosis, consider the use of radioactive tracers but do not use Patent Blue dye if undertaking sentinel node biopsy.
There are insufficient data to change the 2005 recommendation that clinicians should not perform SNB for women who have early-stage breast cancer and are in the following circumstances: Pregnancy
There is some confidence that the recommendation offers the best current guidance for practice. This is based on (1) limited evidence for a true net effect (eg, benefits exceed harms); (2) consistent results, but with important exceptions; (3) concerns about study quality; and/or (4) the extent of panelists’ agreement. Other considerations (discussed in the guideline’s literature review and analyses) may also warrant a weak recommendation
How this guidance was developed
This practice point was developed using an expert consensus process. A potentially relevant ‘weak’ (using ASCO methods) source recommendation was identified from the ASCO 2017 guidelines (US) that recommends against sentinel node biopsy (SNB). The ASCO recommendation was not adopted or adapted because it was considered that SNB can be contemplated depending on the technique used. This practice point was developed to address safety concerns about the potential of Patent Blue dye to cause anaphylaxis, which is of particular concern in pregnant women.
Related guidance by topic
Sentinel node biopsy – Pregnant women
Practice Point
In pregnant women with breast cancer with no clinical or radiological evidence of axillary lymph node metastases at initial diagnosis, consider the use of radioactive tracers but do not use Patent Blue dye if undertaking sentinel node biopsy.
Principles in action
Safe and quality care
This practice point was developed using an expert consensus process. A potentially relevant ‘weak’ (using ASCO methods) source recommendation was identified from the ASCO 2017 guidelines (US) that recommends against sentinel node biopsy (SNB). The ASCO recommendation was not adopted or adapted because it was considered that SNB can be contemplated depending on the technique used. This practice point was developed to address safety concerns about the potential of Patent Blue dye to cause anaphylaxis, which is of particular concern in pregnant women.
Related guidance by topic
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