Magdalena Plasilova, Associate Professor, Department of Surgery at Weill Cornell Medicine, shared on LinkedIn:
“Not every woman with early breast cancer needs her lymph nodes removed.
ASCO’s updated guideline now says clinicians should not routinely do a sentinel lymph node biopsy in some patients.
These are postmenopausal women aged 50 or older with a small (2 cm or less), grade 1–2, HR-positive, HER2-negative cancer, a negative axillary ultrasound, and a planned lumpectomy with whole-breast radiation.
The change rests on the SOUND and INSEMA trials. In INSEMA, 5-year invasive disease-free survival was 91.9% without axillary surgery and 91.7% with it, and patients had less lymphedema and arm pain.
For radiologists, GYNs, and PCPs, the axillary ultrasound and an early surgical consult are where this decision starts. I’m glad to see your newly diagnosed patients promptly at 646-962-2888.”
You can also read:
- A Second Chance at Breast Conservation: Reirradiation Challenges Mastectomy After Local Recurrence
- ASCO 2026 Guideline: A Risk-Adapted Framework for Early HR-Positive, HER2-Negative Breast Cancer
