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Abstract
Purpose To provide current recommendations on the use of sentinel node biopsy (SNB)
for patients with early-stage breast cancer. Methods PubMed and the Cochrane Library
were searched for randomized controlled trials, systematic reviews, meta-analyses,
and clinical practice guidelines from 2012 through July 2016. An Update Panel reviewed
the identified abstracts. Results Of the eight publications identified and reviewed,
none prompted a change in the 2014 recommendations, which are reaffirmed by the updated
literature review. Conclusion Women without sentinel lymph node (SLN) metastases should
not receive axillary lymph node dissection (ALND). Women with one to two metastatic
SLNs who are planning to undergo breast-conserving surgery with whole-breast radiotherapy
should not undergo ALND (in most cases). Women with SLN metastases who will undergo
mastectomy should be offered ALND. These three recommendations are based on randomized
controlled trials. Women with operable breast cancer and multicentric tumors, with
ductal carcinoma in situ, who will undergo mastectomy, who previously underwent breast
and/or axillary surgery, or who received preoperative/neoadjuvant systemic therapy
may be offered SNB. Women who have large or locally advanced invasive breast cancer
(tumor size T3/T4), inflammatory breast cancer, or ductal carcinoma in situ (when
breast-conserving surgery is planned) or are pregnant should not undergo SNB.
To provide evidence-based recommendations to practicing oncologists, surgeons, and radiation therapy clinicians to update the 2005 clinical practice guideline on the use of sentinel node biopsy (SNB) for patients with early-stage breast cancer.