AUTHOR=Huang Tao , Wang Wenkang , Sun Xianfu 

TITLE=Sentinel lymph node biopsy omission in early-stage breast cancer: current evidence and clinical practice

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1598730

DOI=10.3389/fonc.2025.1598730

ISSN=2234-943X

ABSTRACT=Recent trials (e.g., SOUND, INSEMA) indicate that omitting SLNB in patients with small tumors, negative imaging, and favorable prognoses maintains outcomes, reduces complications, and improves quality of life (3,4). Specifically, the INSEMA trial demonstrated that patients who omitted SLNB experienced significantly lower rates of persistent lymphedema (1.8% vs. 5.7%), restriction of arm/shoulder mobility (2.0% vs. 3.5%), and pain with arm/shoulder movement (2.0% vs. 4.2%) compared to those undergoing SLNB. Consequently, guidelines now suggest omitting routine SLNB in elderly patients and those with very low-risk tumors(2). This review summarizes current evidence, eligible populations, theoretical rationale, controversies, and future directions regarding SLNB omission in early breast cancer management.