Sentinel Lymph Node Biopsy in Breast Cancer Treatment: Efficacy and Safety

Currently, breast cancer, the most common type of cancer in women, is often diagnosed at an early stage with a low risk for lymph node metastasis, a major prognostic factor for the course of the disease. Since the mid-1990s, sentinel lymph node biopsy (SLNB) has been proposed as an alternative to axillary lymph node dissection (ALND), the standard tumour staging procedure for this type of cancer. Given that SLNB is a less invasive surgical technique than ALND, its use has spread quickly, even before the publication of long-term efficacy outcomes from major randomized controlled trials.

The Comité de l’évolution des pratiques en oncologie (CEPO) asked INESSS to examine currently available evidence on these issues.

After analyzing the available literature, INESSS has concluded that, in patients with early-stage breast cancer, without clinically detectable adenopathy, the use of axillary lymph node dissection following sentinel lymph node biopsy is not necessary when patients do not present with lymph node metastasis at the definitive anatomical pathology examination.