The sentinel lymph node biopsy has been standard for many years to assess possible metastases. But the procedure is not without risks: patients may suffer from pain, sensory disturbances or lymphedema. Moreover, for many women the outcome of the biopsy appears to have little influence on their further treatment.
“Our study shows that we can safely skip this operation in carefully selected patients,” said Smidt, principal investigator of the trial. “The oncological results remain the same, while you avoid a stressful procedure with possible complications.” In the study, conducted in 25 Dutch hospitals, 1,733 women with early breast cancer were randomized (randomly assigned) to receive SLNB or not. After a five-year follow-up, regional recurrences (recurrence of the cancer in the lymph nodes) were rare in both groups: 0.5% in women with SLNB and 1.2% in women without the procedure. The difference is small and well within the predetermined safety margin.
The results mainly apply to 50+ women with hormone receptor-positive, HER2-negative tumors up to approximately 2 centimeters. “This group makes up the majority of our breast cancer patients in this study,” Smidt said. “For them, this is an important step towards less invasive, more customized care.”
Omitting SLNB also has advantages for patient recovery and healthcare as a whole: shorter operations, fewer complications and lower costs. Smidt does emphasize that good selection and follow-up remain necessary.
The BOOG 2013-08 study was funded by KWF Kankerbestrijding, Zilveren Kruis and ZonMw
