Can Axillary Lymph Node Dissection be Omitted in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes Undergoing Mastectomy? A Systematic Review and Meta‐Analysis of Real‐World Evidence

Chen, Fulong; Li, Xiaowen; Lin, Xiaohui; Chen, Li Jia; Lin, Zhi Xiu; Wu, Hao; Chen, Jishang

doi:10.1007/s00268-023-07072-8

Cited by 2 publications

(2 citation statements)

References 72 publications

(96 reference statements)

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“…Metastasis itself is a multistep process involving local tumor cell invasion, entry into the vasculature, exiting of carcinoma cells from the circulation and colonization at distal sites (15). The local axillary lymph nodes are initially involved in metastatic BC (16). In patients with BC, a detailed and comprehensive assessment of the condition of the axillary lymph nodes is important for determining prognosis (16).…”

Section: Discussionmentioning

confidence: 99%

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Downregulated GPD1 and MAGL protein levels as potential biomarkers for the metastasis of triple‑negative breast tumors to axillary lymph nodes

Simsek,

Bal Albayrak,

Akpinar

et al. 2023

Oncol Lett

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Glycerol-3-phosphate dehydrogenase (GPD1) and monoacylglycerol lipase (MAGL) levels are known to be significantly downregulated in both the tissue and serum samples of patients with triple-negative breast cancer (TNBC), compared with other BC subtypes and healthy controls. As such, the association between GPD1 and MAGL levels and lymph node metastasis was evaluated in the present study. Utilizing western blotting, lymph node protein extracts from metastasized BC subtypes were analyzed and a significant downregulation of GPD1 and MAGL protein expression levels in the lymph node metastases was demonstrated in the TNBC subtype, compared with healthy controls. This finding further highlighted the potential use of these two proteins in early BC onset and metastasis detection.

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Section: Discussionmentioning

confidence: 99%

“…The local axillary lymph nodes are initially involved in metastatic BC (16). In patients with BC, a detailed and comprehensive assessment of the condition of the axillary lymph nodes is important for determining prognosis (16).…”

Section: Discussionmentioning

confidence: 99%

Downregulated GPD1 and MAGL protein levels as potential biomarkers for the metastasis of triple‑negative breast tumors to axillary lymph nodes

Simsek,

Bal Albayrak,

Akpinar

et al. 2023

Oncol Lett

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The prognostic analysis of further axillary dissection in breast cancer with 1-2 positive sentinel lymph nodes undergoing mastectomy

Zhao,

Yang,

Cao

et al. 2024

Front. Oncol.

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BackgroundThe ACOSOG Z0011 study has shown that axillary lymph node dissection (ALND) is an option to be considered in patients who had 1-2 metastatic sentinel lymph nodes (SLNs) who proceed with breast-conserving along with postoperative radiotherapy. However, there remains controversy regarding the applicability of this approach in patients who had a mastectomy. The aim of our study is to determine the prognostic differences and risk factors associated with the decision to opt for ALND in breast cancer patients who had 1-2 metastatic SLNs who receive a mastectomy.MethodsThe study conducted a retrospective analysis of patients diagnosed with cT1-2N0 breast cancer and treated at The Fourth Hospital of Hebei Medical University between January 2016 and December 2021, and patients were divided into two cohorts according to whether ALND was performed after sentinel lymph node biopsy (SLNB): SLNB cohort and SLNB + ALND cohort. Outcomes included the locoregional recurrence rate (LRR), disease-free survival (DFS), and overall survival (OS). Propensity score matching (PSM) was conducted to ensure the balance of variables between the two cohorts. Cox proportional hazard models were employed to ascertain the univariate and multivariate relative risks associated with survival.ResultsThere were 812 cases enrolled. After the PSM, 234 receiving ALND and 234 not receiving ALND were matched. A median follow-up period of 56.72 ± 20.29 months was observed. During that time, no significant difference was identified in the DFS and OS in the SLNB + ALND cohort and the SLNB cohort (P = 0.208 and P = 0.102), except for those under 40 years old, SLNB + ALND group showed a reduction in LRR compared to SLNB group (11.1% vs. 2.12%, P = 0.044). Multivariate Cox analysis showed that younger (≤ 40 years), progesterone receptor (PR)-negative, and SLNB alone were independent risk factors for LRR; perineural invasion was a risk factor, while endocrinotherapy was a beneficial prognostic indicator for DFS and OS among patients with positive hormone receptor.ConclusionALND does not impact DFS and OS in patients with 1-2 metastatic SLNs who have completed a mastectomy. Being younger (≤ 40 years), having a negative PR, and undergoing SLNB alone were independent risk factors for LRR. Given this finding, we recommend avoiding axillary treatment such as ALND or radiotherapy in patients without risk factors.

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Can Axillary Lymph Node Dissection be Omitted in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes Undergoing Mastectomy? A Systematic Review and Meta‐Analysis of Real‐World Evidence

Cited by 2 publications

References 72 publications

Downregulated GPD1 and MAGL protein levels as potential biomarkers for the metastasis of triple‑negative breast tumors to axillary lymph nodes

Downregulated GPD1 and MAGL protein levels as potential biomarkers for the metastasis of triple‑negative breast tumors to axillary lymph nodes

The prognostic analysis of further axillary dissection in breast cancer with 1-2 positive sentinel lymph nodes undergoing mastectomy

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