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Home > Understanding Breast Cancer > Breast Cancer Research > Table 34: Accuracy of sentinel node biopsy in predicting axillary lymph node status

  


Table 34: Accuracy of sentinel node biopsy in predicting axillary lymph node status

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Sentinel node biopsy is the most common way to assess lymph node status. If there is cancer in the lymph nodes, studies show sentinel node biopsy will find it over 90 percent of the time. 

In the past, lymph nodes were assessed using an axillary dissection. Sentinel node biopsy has some advantages over axillary dissection including [1]:

  • Less invasive 
  • Faster recovery time
  • Fewer side effects (such as infection, lymphedema or nerve damage)

For women who are candidates for the procedure, there appears to be no difference in survival when lymph nodes are assessed with sentinel node biopsy alone versus sentinel node biopsy followed by axillary dissection [2-4]. 

Learn more about sentinel node biopsy and axillary dissection.

Learn more about lymph node status and breast cancer prognosis.

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 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 [5]  

2,807

T1, T2, T3

Combined technique

90%

SNAC Trial [6]

509

T1, T2, T3

Blue dye alone or combined technique

95%

Sentinella/GIVOM Trial [7]

352

T1, T2

Radioactive tracer alone

83%

Canavese et al. [3]

248

T1, T2

Combined technique

93%

Meta-analyses 

Kim et al. [8]

8,059

Not available

Blue dye alone,  radioactive tracer or combined technique

96%

Xing et al. [9]

1,273

Not available

Blue dye alone, radioactive tracer or combined technique

90%

 

References 

  1. 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.
  2. Veronesi U, Viale G, Paganelli G, et al. Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study. Ann Surg. 251(4):595-600, 2010.
  3. 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.
  4. Galimberti V, Cole BF, Zurrida S, et al. for the International Breast Cancer Study Group Trial 23-01 investigators. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 14(4):297-305, 2013.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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. 

Updated 09/04/13