Canadian Association of General Surgeons and American College of Surgeons Evidence Based Reviews in Surgery. 23. ASCO recommended guidelines for sentinel lymph node biopsy for early-stage breast cancer. Evidence-based medicine. A new approach to teaching the practice of medicine.
Year: 2007
Type: article
Abstract: Objective: To develop a guideline for the use of sentinel lymph node biopsy (SLNB) in early-stage breast cancer Data sources: Electronic search of MEDLINE, Cochrane Library, Best Evidence, DARE, Dissertation Abstracts, as well as hand-searching techniques Study selection: Only studies that included full lymph node dissection, regardless of the results of SLNB were included. Sixty-nine trials met the eligibility criteria between 1994 and 2004. Data extraction: Studies were extracted and evaluated by 2 blinded observers. Recommendations were based on review of the literature and expert opinion as well as consideration of the Guidelines for Performance of Sentinel Lymph Node Biopsy for Breast Cancer developed by the American Society of Breast Surgeons in 2003. Main results: A review of the available literature, including 1 published randomized controlled trial comparing SNLB with axillary lymph node dissection (ALND), 4 meta-analyses and 69 published single-centre and multicentre trials showed that, when performed by experienced clinicians, SNLB appears to be a safe and acceptably accurate method for identifying early-stage breast cancer without the involvement of the axillary lymph nodes. There are no data on the effect of SLNB on long-term survival. Conclusion: SLNB is an appropriate initial alternative to routine staging with 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 SNLB. However, appropriately identified patients with negative results of SLNB, when done under the directions of an experienced surgeon, need not have completion ALND. Data suggest that SLNB is associated with less morbidity than ALND.
Source: PubMed Central
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W29044509