Ko Un Park, Mark R Somerfield, Nirupama Anne, Muriel Brackstone, Alison K Conlin, Henrique Lima Couto, Lynn T Dengel, Andrea Eisen, Brittany E Harvey, Jeffrey Hawley, Janice N Kim, Nwamaka Lasebikan, Elizabeth S McDonald, Deepti Pradhan, Samantha Shams, Raymond Mailhot Vega, Alastair M Thompson, Mylin A Torres
{"title":"早期乳腺癌前哨淋巴结活检：ASCO指南更新。","authors":"Ko Un Park, Mark R Somerfield, Nirupama Anne, Muriel Brackstone, Alison K Conlin, Henrique Lima Couto, Lynn T Dengel, Andrea Eisen, Brittany E Harvey, Jeffrey Hawley, Janice N Kim, Nwamaka Lasebikan, Elizabeth S McDonald, Deepti Pradhan, Samantha Shams, Raymond Mailhot Vega, Alastair M Thompson, Mylin A Torres","doi":"10.1200/JCO-25-00099","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To update the ASCO evidence-based recommendations on the use of sentinel lymph node biopsy (SLNB) in patients with early-stage breast cancer treated with initial surgery.</p><p><strong>Methods: </strong>ASCO convened an Expert Panel to develop updated recommendations based on a systematic literature review (January 2016-May 2024).</p><p><strong>Results: </strong>Eleven randomized clinical trials (14 publications), eight meta-analyses and/or systematic reviews, and one prospective cohort study met the inclusion criteria for this systematic review. Expert Panel members used available evidence and informal consensus to develop practice recommendations.</p><p><strong>Recommendations: </strong>Clinicians should not recommend routine SLNB in select patients who are postmenopausal and ≥50 years of age and with negative findings on preoperative axillary ultrasound for grade 1-2, small (≤2 cm), hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer and who undergo breast-conserving therapy. Clinicians may offer postmastectomy radiation (RT) with regional nodal irradiation (RNI) and omit axillary lymph node dissection (ALND) in patients with clinically node-negative invasive breast cancer ≤5 cm who receive mastectomy and have one to two positive sentinel nodes. Clinicians may offer SLNB in patients who have cT3-T4c or multicentric tumors (clinically node-negative) or ductal carcinoma in situ treated with mastectomy, and in patients who are obese, male, or pregnant, or who have had prior breast or axillary surgery. Clinicians should not recommend ALND for patients with early-stage breast cancer who do not have nodal metastases, and clinicians should not recommend ALND for patients with early-stage breast cancer who have one or two sentinel lymph node metastases and will receive breast-conserving surgery and whole-breast RT with or without RNI.Additional information is available at www.asco.org/breast-cancer-guidelines.This guideline has been endorsed by the American Society for Radiation Oncology (ASTRO).</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":"43 14","pages":"1720-1741"},"PeriodicalIF":42.1000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.\",\"authors\":\"Ko Un Park, Mark R Somerfield, Nirupama Anne, Muriel Brackstone, Alison K Conlin, Henrique Lima Couto, Lynn T Dengel, Andrea Eisen, Brittany E Harvey, Jeffrey Hawley, Janice N Kim, Nwamaka Lasebikan, Elizabeth S McDonald, Deepti Pradhan, Samantha Shams, Raymond Mailhot Vega, Alastair M Thompson, Mylin A Torres\",\"doi\":\"10.1200/JCO-25-00099\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To update the ASCO evidence-based recommendations on the use of sentinel lymph node biopsy (SLNB) in patients with early-stage breast cancer treated with initial surgery.</p><p><strong>Methods: </strong>ASCO convened an Expert Panel to develop updated recommendations based on a systematic literature review (January 2016-May 2024).</p><p><strong>Results: </strong>Eleven randomized clinical trials (14 publications), eight meta-analyses and/or systematic reviews, and one prospective cohort study met the inclusion criteria for this systematic review. Expert Panel members used available evidence and informal consensus to develop practice recommendations.</p><p><strong>Recommendations: </strong>Clinicians should not recommend routine SLNB in select patients who are postmenopausal and ≥50 years of age and with negative findings on preoperative axillary ultrasound for grade 1-2, small (≤2 cm), hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer and who undergo breast-conserving therapy. Clinicians may offer postmastectomy radiation (RT) with regional nodal irradiation (RNI) and omit axillary lymph node dissection (ALND) in patients with clinically node-negative invasive breast cancer ≤5 cm who receive mastectomy and have one to two positive sentinel nodes. Clinicians may offer SLNB in patients who have cT3-T4c or multicentric tumors (clinically node-negative) or ductal carcinoma in situ treated with mastectomy, and in patients who are obese, male, or pregnant, or who have had prior breast or axillary surgery. 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Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.
Purpose: To update the ASCO evidence-based recommendations on the use of sentinel lymph node biopsy (SLNB) in patients with early-stage breast cancer treated with initial surgery.
Methods: ASCO convened an Expert Panel to develop updated recommendations based on a systematic literature review (January 2016-May 2024).
Results: Eleven randomized clinical trials (14 publications), eight meta-analyses and/or systematic reviews, and one prospective cohort study met the inclusion criteria for this systematic review. Expert Panel members used available evidence and informal consensus to develop practice recommendations.
Recommendations: Clinicians should not recommend routine SLNB in select patients who are postmenopausal and ≥50 years of age and with negative findings on preoperative axillary ultrasound for grade 1-2, small (≤2 cm), hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer and who undergo breast-conserving therapy. Clinicians may offer postmastectomy radiation (RT) with regional nodal irradiation (RNI) and omit axillary lymph node dissection (ALND) in patients with clinically node-negative invasive breast cancer ≤5 cm who receive mastectomy and have one to two positive sentinel nodes. Clinicians may offer SLNB in patients who have cT3-T4c or multicentric tumors (clinically node-negative) or ductal carcinoma in situ treated with mastectomy, and in patients who are obese, male, or pregnant, or who have had prior breast or axillary surgery. Clinicians should not recommend ALND for patients with early-stage breast cancer who do not have nodal metastases, and clinicians should not recommend ALND for patients with early-stage breast cancer who have one or two sentinel lymph node metastases and will receive breast-conserving surgery and whole-breast RT with or without RNI.Additional information is available at www.asco.org/breast-cancer-guidelines.This guideline has been endorsed by the American Society for Radiation Oncology (ASTRO).
期刊介绍：
The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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