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ASCO Updates Guideline for SNB in Early-Stage Breast Cancer

ASCO Updates Guideline for SNB in Early-Stage Breast Cancer
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THURSDAY, Dec. 22, 2016 (HealthDay News) — Recommendations for use of sentinel node biopsy (SNB) in early-stage breast cancer are unchanged from 2014, according to a clinical practice guideline update published online Dec. 12 in the Journal of Clinical Oncology.

Gary H. Lyman, M.D., M.P.H., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues conducted a systematic literature review to provide current recommendations on the use of SNB for patients with early-stage breast cancer.

The researchers found that none of the eight publications identified and reviewed prompted a change in the 2014 recommendations. Axillary lymph node dissection (ALND) is not recommended for women without sentinel lymph node (SLN) metastases. In most cases, women with one to two metastatic SLNs who intend to undergo breast-conserving surgery with whole-breast radiotherapy should not undergo ALND. ALND should be offered to women with SLN metastases who will undergo mastectomy. These recommendations are based on data from randomized controlled trials. SNB may be offered to 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.

“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,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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