Authors' objectives:

To update existing assessments of sentinel node biopsy (SNB), focusing on its feasibility and reliability, the technical steps of the procedure, its impact on surgery and on an economic analysis.

Authors' results and conclusions: Feasibility and reliability: SNB was feasible and was able to diagnose lymph node involvement under certain surgical and analytical conditions. The examination has been incorporated into TNM staging since 2003 (6th edition). A meta-analysis and 5 systematic reviews have reported 66-100% identification of the SN, with 0-17% false negatives depending on the study (10 preliminary studies of more than 100 patients, with SNB followed by axillary clearance (AC)). Technical steps of the procedure: One of the 12 studies on choice of tracer was randomised, but case series studying isotope methods, injection site, and learning curve had many design deficiencies. The histopathology methods used varied and were not standardised. Impact on surgery: One of the two prospective unrandomised studies and 2 case series did not show any recurrence in patients without SN involvement who had not undergone AC. No comparative trials (with AC) have assessed short- and medium-term local and regional complications, nor long-term follow-up (disease control and survival). These trials, and a trial of the impact of SNB on management strategies for breast cancer and quality of life, are in progress.

Authors' recommendations: SNB is feasible. Technical steps must be standardized. No comparative trial with AC is available to assess the regional complications and long term follow-up.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.has-sante.fr/

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: L'Agence Nationale d'Accreditation d'Evaluation en Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: sh.leerobin@has-sante.fr

Contact Email: sh.leerobin@has-sante.fr

Copyright: L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)