# Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.

**Organizacion:** ASCO
**Autores:** Park KU, Somerfield MR, Anne N et al.
**Revista:** J Clin Oncol (2025)
**PMID:** 40209128 | **PMCID:** -
**DOI:** [10.1200/JCO-25-00099](https://doi.org/10.1200/JCO-25-00099)
**Fuente:** PubMed (abstract only)

## Relevancia
Guia oficial de la American Society of Clinical Oncology que estandariza el manejo axilar en cancer de mama estadio temprano, incluyendo recomendaciones especificas tras quimioterapia neoadyuvante (NAC). Define cuando es aceptable la biopsia selectiva de ganglio centinela (BSGC) post-NAC y cuando persiste la indicacion de linfadenectomia (ALND), basandose en revision sistematica de literatura.

## Recomendaciones clave (resumen)
- BSGC post-NAC permitida en pacientes cN0 que se convierten a ypN0 (no requiere ALND).
- En pacientes cN+ al diagnostico, la ALND tradicional sigue siendo estandar, aunque la BSGC con tecnicas que mejoran identificacion (TAD, doble trazador) es opcion aceptable en respondedoras.
- Recomienda no realizar ALND en pacientes con BSGC negativa post-NAC.
- Marcaje del ganglio sospechoso al diagnostico se considera buena practica para mejorar precision.

## Abstract
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.

ASCO convened an Expert Panel to develop updated recommendations based on a systematic literature review (January 2016-May 2024).

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.

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).

## Acceso
Via [DOI](https://doi.org/10.1200/JCO-25-00099) o suscripcion institucional.

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*Datos de PubMed. Citar: doi 10.1200/JCO-25-00099*
