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Meta-Analysis
. 2022 Aug 1;23(8):2561-2571.
doi: 10.31557/APJCP.2022.23.8.2561.

Comparing Early-Stage Breast Cancer Patients with Sentinel Lymph Node Metastasis with and without Completion Axillary Lymph Node Dissection: A Systematic Review and Meta-Analysis

Naeimeh Heiranizadeh  1 , Mohammad Rafiei Shahamabadi  1 , Hamid Reza Dehghan  2 , Jamal Jafari-Nedooshan  1 , Saeid Kargar  1 , Mohammad Zare  1 , Abdolhamid Amooei  1 , Seyed Mostafa Shiryazdi  1 , Mohammad Ali Broomand  3 , Mohammad Taghi Moravej  2 , Zahra Sadri  4
Affiliations
Meta-Analysis

Comparing Early-Stage Breast Cancer Patients with Sentinel Lymph Node Metastasis with and without Completion Axillary Lymph Node Dissection: A Systematic Review and Meta-Analysis

Naeimeh Heiranizadeh et al. Asian Pac J Cancer Prev. .

Abstract

Background: Currently, the standard method for staging and treatment of axillary lymph nodes for early-stage breast cancer is sentinel lymph node biopsy (SLNB), while axillary lymph node dissection (ALND) is used in cases with palpable axillary lymph nodes or positive SLNB cases. The aim of this review was to compare overall survival (OS), disease-free survival (DFS), and axillary recurrence in early-stage breast cancer patients underwent SLNB or SLNB and completion ALND.

Methods: The databases of PubMed, Scopus, and Cochrane Library were searched using the key words of "breast cancer", "axillary lymph node dissection", and "sentinel lymph node dissection". In addition, other sources were searched for ongoing studies (i.e., clinicaltrials.gov). The clinical trials were evaluated based on the Jadad quality criteria, and cohort studies were evaluated according to the STROBE criteria. At the end of the search, the articles were screened independently by two reviewers to check their eligibility to be included in the study. Afterwards, the data were extracted independently by two researchers.

Results: After searching the databases, 169 papers were retrieved. However, after removing the duplicates and studying the titles and abstracts of these papers, only ten ones underwent further investigation. After reading full-text of each article, four studies were finalized. Following a manual search, 27 papers were entered into the study for the final evaluation, 11 of which were included in the meta-analysis based on the inclusion and exclusion criteria. The findings showed no significant differences in OS, DFS, and axillary recurrence in early-stage breast cancer patients underwent SLNB or SLNB and completion ALND.

Conclusion: The findings did not confirm that ALND improved OS, DFS, and axillary recurrence in patients who were clinically node-negative and positive SLNB.

Keywords: axillary lymph node dissection; early-stage breast cancer; sentinel lymph node biopsy; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA Flow Diagram
Figure 2
Figure 2
Meta-Analysis for OS Pooling of Hazard Ratios Using Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau²
Figure 3
Figure 3
Meta-Analysis for DFS Pooling of Hazard Ratios Using Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau2
Figure 4
Figure 4
Meta-Analysis for Axillary Recurrence Pooling of Hazard Ratios Using Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau2
Figure 5
Figure 5
Meta-Analysis for OS in RCT Subgroup Pooling of Hazard Ratios Using Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau2
Figure 6
Figure 6
Meta-Analysis for DFS in RCT Subgroup Pooling of Hazard Ratios Using Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau2
Figure 7
Figure 7
Meta-Analysis for OS in Cohort Subgroup Pooling of Hazard Ratios Using the Random Effects Inverse-Variance Model with DerSimonian-Laird estimate of tau2
Figure 8
Figure 8
Meta-Analysis for DFS in Cohort Subgroup Pooling of Hazard Ratios Using the Random Effects Inverse-Variance Model with DerSimonian-Laird Estimate of tau2
See this image and copyright information in PMC

References

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