Should we be performing sentinel lymph node biopsies for HR+ patients ≥70 years of age?
In light of updated monarchE trial data, it seems a SLNB would help delineate adjuvant treatment options in this population. However, Choosing Wisely guidelines from the Society of Surgical Oncology currently recommend against SNLB in clinically node negative women ≥ 70 years of age with early stage hormone receptor positive, HER2 negative invasive breast cancer.
What are your thoughts? Should these guidelines be updated?
Link:
https://www.choosingwisely.org/societies/society-of-surgical-oncology/
https://www.sciencedirect.com/science/article/pii/S0923753421044914?via%3Dihub
2 Answers
Mednet MemberInvited Expert
Medical Oncology · Harvard Medical School
Answered on
I do not think that the monarchE data for adjuvant abemaciclib warrants changing our standard practice around omission of SLNB for patients >/= 70 yo with low-risk HR+/HER2- tumors that are clinically node-negative, because adjuvant abemaciclib is largely only appropriate for higher risk tumors and ...
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Mednet MemberInvited Expert
Medical Oncology · Lewisburg Cancer Center | Evangelical Hospital
Answered on
This question brings up another important issue in clinical practice regarding the Commission on Cancer (CoC) Survey Standards requirements.
When a surgeon elects to follow Choosing Wisely recommendations in women >70 years, hormone (+) and a clinically negative axilla, those cases are coded by tumo...
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