What are the ACBS guidelines for sentinel lymph node (SLN) biopsy in the surgical treatment of breast cancer?

Updated: Feb 13, 2019
  • Author: Mary Jo Wright, MD; Chief Editor: James Neal Long, MD, FACS  more...
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Sentinel lymph node (SLN) biopsy is currently preferred for axillary staging, because it offers accuracy equivalent to that of ALND with less morbidity. [3] The American College of Breast Surgeons (ACBS) states the following:

  • SLN biopsy is suitable for virtually all patients with clinically node-negative T1-2 invasive breast cancers

  • Limited data are available regarding the suitability of SLN biopsy for patients with T3 cancers, multifocal/multicentric disease, prior radiation therapy, or prior breast/axillary surgery

  • SLN biopsy appears to be feasible in patients who have had minimal axillary surgery; the decision to use it in these situations requires individualized surgical judgment and an unequivocally successful mapping procedure

  • SLN biopsy is also indicated in patients with ductal carcinoma in situ (DCIS) in whom mastectomy is required or invasive disease is suspected

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