The summary of the published interventional procedure on Endoscopic axillary lymph node retrieval for breast cancer. It links to the published guidance and key documents.
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14 December 2005
5 About this guidance
NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland.
This guidance was developed using the NICE interventional procedure guidance process.
It has been incorporated into the NICE pathway on early and locally advanced breast cancer , along with other related guidance and products.
We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available .
This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties.
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4 Changes since publication
The guidance was considered for reassessment in December 2008 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us .
22 January 2012: minor maintenance.
2.3.1 Conversion to open surgery was reported in 8% (4/53) of operations in a historically controlled study. In a large case series, only 2% (2/100) of operations were converted to open surgery.
2.3.2 In one randomised controlled trial, the operative time for endoscopic axillary lymph node retrieval was found to be significantly longer than for open surgery (mean time 61 and 33 minutes, respectively).
2.3.3 One quasi-randomised study found good shoulder?arm mobility at 7 days postoperatively, with more than 90% mobility being achieved after either endoscopic axillary lymph node retrieval or open surgery. Only 18% (7/40) of patients who had endoscopic axillary lymph node retrieval reported pain on the first postoperative day, compared with 33% (13/40) of patients who had open surgery. One small randomised controlled trial found that all ten patients reported no pain at 3 days after endoscopic axillary lymph node retrieval.
2.3.4 Length of hospital stay after endoscopic axillary lymph node retrieval varied from 2.5 days to 9 days, although one study reported that most of the later patients in the series were discharged within 24 hours.
2.3.5 Two case series reported no axillary recurrence among 100 patients followed up to 14 months, and 103 patients followed up to 18 months. For more details, refer to the Sources of evidence.