Axillary lymph node dissection vs. sentinel node biopsy for early-stage clinically node-negative breast cancer: a systematic review and meta-analysis

Petousis, Stamatios; Christidis, Panagiotis; Margioula‐Siarkou, Chrysoula; Liberis, Anastasios; Vavoulidis, Εleftherios; Margioula–Siarkou, Georgia; Vatopoulou, Anastasia; Παπανικολάου, Αλέξιος; Mavromatidis, Georgios; Dinas, Konstantinos

doi:10.1007/s00404-022-06458-8

Cited by 6 publications

(6 citation statements)

References 38 publications

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“…These advantages are reflected in the meta-analysis results that support the preferential use of sentinel node biopsy. Routine axillary lymph node dissection does not provide any survival benefit compared with sentinel lymph node dissection in patients with clinically node-negative early-stage breast cancer [ 31 ]. Therefore, axillary lymphadenectomy for unaffected clinically and radiologically lymphatic nodes is no longer an acceptable practice in breast cancer [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia

González Mariño

2024

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BACKGROUND: Sentinel lymph node biopsy in breast cancer is considered the standard of staging in cases of clinically negative lymph nodes. Its omission in favor of axillary dissection generates significant morbidity. OBJECTIVE: To determine the total number of sentinel node biopsy procedures in breast cancer in Colombia from 2017 through 2020, model and analyze them as if they were performed only in stage I breast cancer patients, and integrate their results into the concepts of quality of medical care. METHODS: Search in a database of the Ministry of Health and Social Protection of Colombia with sentinel lymph node biopsy codes, and filters of breast cancer and year. Their results are contrasted with the number of cases in stage I of breast cancer. RESULTS: Breast cancer TNM staging was reported in 22154 cases, 3648 stage I. In the same time frame, the number of sentinel lymph node biopsies for breast cancer in Colombia was 1045, 28.64% of the total cases reported in stage I. CONCLUSIONS: Colombia is far from complying with the standard indicator of sentinel lymph node biopsy. It is recommended to concentrate breast cancer cases in hospitals that provide the conditions for its performance.

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Section: Discussionmentioning

confidence: 99%

Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia

González Mariño

2024

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“…Several studies have concluded that breast-conserving surgery with SLNB followed by total breast radiation therapy is oncologically acceptable and ALND may be omitted in these patients without significant impact on their overall and disease-free survival. [8][9][10][11] However, pregnant patients with PrBC consist a special patient population in which precautions should be considered in order to reassure maternal and foetal safety. Potential concerns may include foetal harm from radiation exposure, possible teratogenic effects of blue dye and maternal anaphylaxis to isosulfan.…”

Section: Introductionmentioning

confidence: 99%

“…SLNB is currently worldwide considered as the standard of care for staging in early‐stage, clinically node‐negative breast cancer. Several studies have concluded that breast‐conserving surgery with SLNB followed by total breast radiation therapy is oncologically acceptable and ALND may be omitted in these patients without significant impact on their overall and disease‐free survival 8–11 . However, pregnant patients with PrBC consist a special patient population in which precautions should be considered in order to reassure maternal and foetal safety.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

Bothou,

Margioula‐Siarkou,

Petousis

et al. 2023

Eur J Clin Investigation

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BackgroundPregnant patients diagnosed with breast cancer (PrBC) may receive substantially different treatments compared to general population, considering that certain treatment options cannot be applied during pregnancy due to their potential harmful effects to the foetus. Regarding the use of sentinel lymph node biopsy (SLNB) in pregnant patients, potential concerns include foetal harm from radiation exposure, possible teratogenic effects of blue dyes and maternal anaphylaxis to isosulfan.ObjectiveThe main objective of the present systematic review is to summarize and present current knowledge and up‐to‐date evidence about the safety and efficacy of SLNB in PABC.MethodsMEDLINE, Google Scholar and UpToDate databases were searched up to 22 January 2023. Articles studying the safety and effectiveness of SLNB in patients for PrBC were eligible for inclusion in the present review.ResultsIn total, 63 articles that met the inclusion criteria were included in this study. Forty‐seven articles were strongly in favour of performing SLNB in PABC, 4 articles were partially in favour, 10 articles were strongly against and 2 articles were partially against performing SLNB in PABC. Sub‐categorization based on type of study showed that the majority of studies in favour were of higher level of evidence than those against. Furthermore, there were overall 12 studies reporting on outcomes. There were overall 382 women with PrBC that underwent SLNB. Full data were reported for 237 cases. Overall live birth rate was 95.8%, while overall neonatal complication rate was 3.4%.No case of maternal side effects or anaphylactic reaction, maternal death, stillbirth and neonatal death was reported (0%).ConclusionsSentinel lymph node biopsy seems to be safe and effective technique for breast cancer during pregnancy.

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“…At present, breast cancer has become the malignant tumor with the highest incidence in women (1), and the onset of breast cancer has been occurring at younger and younger ages. Axillary lymph node dissection (ALND) is an effective method of maintaining regional control; however, it is associated with a significant risk of complications such as lymphedema, numbness, axillary web syndrome, and decreased upper-extremity range of motion (2,3). The Z0011 trial conducted by the American College of Surgeons Oncology Group (ACOSOG) showed that if the postoperative treatments are standardized, patients with one or two positive lymph nodes in sentinel lymph node biopsy (SLNB) do not need an ALND (2,4).…”

Section: Introductionmentioning

confidence: 99%

Identification of the lymph node metastasis-related automated breast volume scanning features for predicting axillary lymph node tumor burden of invasive breast cancer via a clinical prediction model

et al. 2022

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Breast cancer has become the malignant tumor with the highest incidence in women. Axillary lymph node dissection (ALND) is an effective method of maintaining regional control; however, it is associated with a significant risk of complications. Meanwhile, whether the patients need ALND or not is according to sentinel lymph node biopsy (SLNB). However, the false-negative results of SLNB had been reported. Automated breast volume scanning (ABVS) is a routine examination in breast cancer. A real-world cohort consisting of 245 breast cancer patients who underwent ABVS examination were enrolled, including 251 tumor lesions. The ABVS manifestations were analyzed with the SLNB results, and the ALND results for selecting the lymph node metastasis were related to ABVS features. Finally, a nomogram was used to construct a breast cancer axillary lymph node tumor burden prediction model. Breast cancer patients with a molecular subtype of luminal B type, a maximum lesion diameter of ≥5 cm, tumor invasion of the Cooper’s ligament, and tumor invasion of the nipple had heavy lymph node tumor burden. Molecular classification, tumor size, and Cooper’s ligament status were used to construct a clinical prediction model of axillary lymph node tumor burden. The consistency indexes (or AUC) of the training cohort and the validation cohort were 0.743 and 0.711, respectively, which was close to SLNB (0.768). The best cutoff value of the ABVS nomogram was 81.146 points. After combination with ABVS features and SLNB, the AUC of the prediction model was 0.889, and the best cutoff value was 178.965 points. The calibration curve showed that the constructed nomogram clinical prediction model and the real results were highly consistent. The clinical prediction model constructed using molecular classification, tumor size, and Cooper’s ligament status can effectively predict the probability of heavy axillary lymph node tumor burden, which can be the significant supplement to the SLNB. Therefore, this model may be used for individual decision-making in the diagnosis and treatments of breast cancer.

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Axillary lymph node dissection vs. sentinel node biopsy for early-stage clinically node-negative breast cancer: a systematic review and meta-analysis

Cited by 6 publications

References 38 publications

Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia

Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

Identification of the lymph node metastasis-related automated breast volume scanning features for predicting axillary lymph node tumor burden of invasive breast cancer via a clinical prediction model

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