Intraoperative tests (RD‑100i OSNA system and Metasin test) for detecting sentinel lymph node metastases in breast cancer

Whole lymph node analysis using the RD‑100i OSNA system is recommended as an option for detecting sentinel lymph node metastases during breast surgery in people with early invasive breast cancer who have a sentinel lymph node biopsy and in whom axillary lymph node dissection will be considered. Details of the development of a national registry are included in section 7 of this guidance.

The Metasin test is not recommended for detecting sentinel lymph node metastases in people with early invasive breast cancer in routine clinical NHS practice. The Metasin test shows promise and the development of robust evidence is recommended to demonstrate its utility in clinical practice.