The Who, What, Where, When and Sometimes, Why.

Accuracy of sentinel node biopsy

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Sentinel node biopsy is the main way to assess lymph node status. If there’s cancer in the lymph nodes, sentinel node biopsy will find it over 90 percent of the time [1].

In the past, lymph nodes were assessed using axillary dissection. Now, only some people who have positive sentinel lymph nodes will need an axillary dissection.

Compared to axillary dissection, sentinel node biopsy [2]:

  • Is less invasive
  • Has a faster recovery time
  • Has fewer side effects (such as infection, lymphedema and nerve damage)

Learn more about sentinel node biopsy and axillary dissection.

Learn about lymph node status and breast cancer prognosis (chances of survival).

Learn about lymph node status and staging.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Randomized clinical trials with at least 200 participants and meta-analyses.

Table note: Sensitivity in the table below measures how accurately sentinel node biopsy identified lymph node status.

For example, a sensitivity of 90 percent means 90 percent of the people the sentinel node biopsy identified as having positive lymph nodes did, in fact, have cancer in their lymph nodes when checked with axillary dissection.

Study

Study Population
(number of participants)

Tumor Stage

Method Used
(blue dye, radioactive tracer or combined technique)

Accuracy in Predicting Lymph Node Status, Sensitivity %

Randomized clinical trials

NSABP B-32 Trial [3]

2,807

T1, T2, T3

Combined technique

90%

SNAC Trial [4]

509

T1, T2, T3

Blue dye alone or combined technique

95%

Sentinella/GIVOM Trial [5]

352

T1, T2

Radioactive tracer alone

83%

Canavese et al. [6]

248

T1, T2

Combined technique

93%

Meta-analyses

Kim et al. [7]

8,059

Not available

Blue dye alone, radioactive tracer or combined technique

96%

Xing et al. [8]

1,273

Not available

Blue dye alone, radioactive tracer or combined technique

90%

References

  1. Cody HS III and Plitas G. Chapter 38: Axillary Dissection, in Harris JR, Lippman ME, Morrow M, Osborne CK. Diseases of the Breast, 5th edition, Lippincott Williams & Wilkins, 2014.
  2. Kell MR, Burke JP, Barry M, Morrow M. Outcome of axillary staging in early breast cancer: a meta-analysis. Breast Cancer Res Treat. 120(2):441-447, 2010.
  3. Krag DN, Anderson SJ, Julian TB, et al. for the National Surgical Adjuvant Breast and Bowel Project Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 8(10):881-8, 2007.
  4. Gill G for the SNAC Trial Group of the Royal Australasian College of Surgeons (RACS) and NHMRC Clinical Trials Centre. Sentinel-lymph-node-based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): a randomized controlled surgical trial. Ann Surg Oncol. 16(2):266-75, 2009.
  5. Zavagno G, De Salvo GL, Scalco G, et al. for the GIVOM Trialists. A randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Ann Surg. 247(2):207-13, 2008.
  6. Canavese G, Catturich A, Vecchio C, et al. Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes: results of randomized trial. Ann Oncol. 20(6):1001-7, 2009.
  7. Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: A metaanalysis. Cancer. 106(1):4-16, 2006.
  8. Xing Y, Foy M, Cox DD, et al. Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg. 93(5):539-46, 2006.

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