ArticleCancer2025
Implications of omitting sentinel lymph node biopsy on adjuvant decision making for patients with small breast cancers.
Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Role of Sentinel Node Surgery in Identifying Candidates for Adjuvant CDK4/6 Inhibitors: Implications of Choosing Wisely and ASCO Omission Criteria.Annals of surgical oncology · 2026Article
- Omission of Sentinel Lymph Node Biopsy Among Women Aged 50 to 70 With Early-Stage Breast Cancer: Applying an Updated ASCO Guideline to a Real-World Population.Practical radiation oncology · 2026Article
- De-Escalation of Axillary Surgery: A Review of Choosing Wisely Guideline Evidence.World journal of oncology · 2026Review
- Evaluating the role of sentinel lymph node biopsy in cT1-2N0M0 breast cancer: a SEER-based study.Gland surgery · 2025Article
- Article
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Authors and funding
17 authors.
Funding
Abstract
backgroundSelective omission of sentinel lymph node biopsy (SLNB) in patients with early breast cancer limits surgical morbidity. Adoption of this strategy relies on multidisciplinary consensus. Understanding how SLNB omission influences guideline-based adjuvant treatment decisions, and the proportion of patients impacted, can help guide decision-making. PATIENTS AND
methodsData from the National Cancer Database (2018-2020) was used to estimate the proportions of patients with cT1N0 hormone receptor-positive breast cancer for whom adjuvant chemotherapy, CDK4/6 inhibitor therapy, and regional nodal irradiation decisions would be impacted by the absence of lymph node pathology if national treatment guidelines were followed. Because OncotypeDX score is essential to adjuvant decision-making when SLNB is omitted, inverse probability weighting was used to estimate the proportions of interest had all individuals undergone OncotypeDX testing.
resultsThere were 119,312 included patients, with an average age of 63 years, 96,454 (80.8%) having invasive ductal histology, and 52,222 (43.8%) having cT1c tumors. The number of patients with SLNB positivity was 13,211 (11.1%). Among postmenopausal women, 7.9% (95% CI, 7.7-8.1) would have had at least one adjuvant decision impacted by the absence of lymph node pathology. For premenopausal women, the affected proportion was 13.7% (95% CI, 13.0-14.7). When ribociclib decision-making was not considered, these estimates were 2.5% for postmenopausal women and 12.6% for premenopausal women.
conclusionsSLNB omission has a small - but not negligible - influence on adjuvant decision making in postmenopausal women, whereas a larger proportion of premenopausal women would be impacted. The reported estimates may inform multidisciplinary decision-making related to SLNB omission.
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