Research table: Accuracy of sentinel lymph 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 lymph node biopsy is the main way to check if breast cancer has spread to the axillary lymph nodes (the lymph nodes in the underarm area). If there’s cancer in the lymph nodes, sentinel node biopsy will find it over 90% of the time [1].

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

Compared to axillary lymph node dissection, sentinel lymph node biopsy:

• 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 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 lymph node biopsy identified lymph node status.

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

Study	Study Population (number of participants)	Tumor Stage	Method Used (blue dye, radioactive tracer or combined technique)	Sensitivity (Accuracy) in Predicting Lymph Node Status
Randomized clinical trials
NSABP B-32 Trial [2]	2,807	T1, T2, T3	Combined technique	90%
SNAC Trial [3]	509	T1, T2, T3	Blue dye alone or combined technique	95%
Sentinella/GIVOM Trial [4]	352	T1, T2	Radioactive tracer alone	83%
Canavese et al. [5]	248	T1, T2	Combined technique	93%
Meta-analyses
Kim et al. [6]	8,059	Not available	Blue dye alone, radioactive tracer or combined technique	96%
Xing et al. [7]	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. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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 10/04/24