Juan C Vázquez1, Antonio Piñero2, Francisco Javier de Castro3, Ana Lluch4, Miguel Martín5, Agustí Barnadas6, Emilio Alba7, Álvaro Rodríguez-Lescure8, Federico Rojo9, Julia Giménez10, Iván Solá11, María Jesús Quintana11, Xavier Bonfill12, Gerard Urrutia12, Pedro Sánchez-Rovira13. 1. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain. jvazquezn@santpau.cat. 2. Hospital Clinico Universitario Virgen de la Arrixaca de Murcia, GEICAM Spanish Breast Cancer Group, Murcia, Spain. 3. Hospital Nuestra Señora de Sonsoles de Ávila, GEICAM Spanish Breast Cancer Group, Ávila, Spain. 4. Medical Oncology Unit, Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Universidad de Valencia, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Valencia, Spain. 5. Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Madrid, Spain. 6. Medical Oncology Department, Hospital de la Santa Creu I Sant Pau de Barcelona, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Barcelona, Spain. 7. UGCI Oncología Médica, Hospitales Regional y Virgen de la Victoria, IBIMA. Málaga, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Málaga, Spain. 8. Hospital General Universitario de Elche, GEICAM Spanish Breast Cancer Group, Alicante, Spain. 9. Hospital Universitario Fundacion Jimenez Diaz de Madrid, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Madrid, Spain. 10. Instituto Valenciano de Oncologia-IVO- GEICAM Spanish Breast Cancer Group, Valencia, Spain. 11. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. 12. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma de Barcelona, Barcelona, Spain. 13. Medical Oncology Unit, Complejo Hospitalario de Jaén, GEICAM Spanish Breast Cancer Group, Jaén, Spain.
Abstract
PURPOSE: We conducted a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) after the neoadjuvant chemotherapy, compared to axillary lymph-node dissection, in terms of false-negative rate (FNR) and sentinel lymph-node identification rate (SLNIR), sensitivity, negative predictive value (NPV), need for axillary lymph-node dissection (ALND), morbidity, preferences, and costs. METHODS: MEDLINE, Embase, Scopus, and The Cochrane Library were searched. We assessed the quality of the included systematic reviews using AMSTAR2 tool, and estimated the degree of overlapping of the individual studies on the included reviews. RESULTS: Six systematic reviews with variable quality were selected. We observed a very high overlapping degree across the included reviews. The FNR and the SLNIR were quite consistent (FNR 13-14%; SLNIR ~ 90% or higher). In women with initially clinically node-negative breast cancer, the FNR was better (6%), with similar SLNIR (96%). The included reviews did not consider the other prespecified outcomes. CONCLUSIONS: It would be reasonable to suggest performing an SLNB in patients treated with NACT, adjusting the procedure to the previous marking of the affected lymph node, using double tracer, and biopsy of at least three sentinel lymph nodes. More well-designed research is needed. PROSPERO registration number: CRD42020114403.
PURPOSE: We conducted a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) after the neoadjuvant chemotherapy, compared to axillary lymph-node dissection, in terms of false-negative rate (FNR) and sentinel lymph-node identification rate (SLNIR), sensitivity, negative predictive value (NPV), need for axillary lymph-node dissection (ALND), morbidity, preferences, and costs. METHODS: MEDLINE, Embase, Scopus, and The Cochrane Library were searched. We assessed the quality of the included systematic reviews using AMSTAR2 tool, and estimated the degree of overlapping of the individual studies on the included reviews. RESULTS: Six systematic reviews with variable quality were selected. We observed a very high overlapping degree across the included reviews. The FNR and the SLNIR were quite consistent (FNR 13-14%; SLNIR ~ 90% or higher). In women with initially clinically node-negative breast cancer, the FNR was better (6%), with similar SLNIR (96%). The included reviews did not consider the other prespecified outcomes. CONCLUSIONS: It would be reasonable to suggest performing an SLNB in patients treated with NACT, adjusting the procedure to the previous marking of the affected lymph node, using double tracer, and biopsy of at least three sentinel lymph nodes. More well-designed research is needed. PROSPERO registration number: CRD42020114403.
Authors: Judy C Boughey; Karla V Ballman; Kelly K Hunt; Linda M McCall; Elizabeth A Mittendorf; Gretchen M Ahrendt; Lee G Wilke; Huong T Le-Petross Journal: J Clin Oncol Date: 2015-02-02 Impact factor: 44.544
Authors: Brigid K Killelea; Vicky Q Yang; Sarah Mougalian; Nina R Horowitz; Lajos Pusztai; Anees B Chagpar; Donald R Lannin Journal: J Am Coll Surg Date: 2015-02-26 Impact factor: 6.113
Authors: Abigail S Caudle; Wei T Yang; Savitri Krishnamurthy; Elizabeth A Mittendorf; Dalliah M Black; Michael Z Gilcrease; Isabelle Bedrosian; Brian P Hobbs; Sarah M DeSnyder; Rosa F Hwang; Beatriz E Adrada; Simona F Shaitelman; Mariana Chavez-MacGregor; Benjamin D Smith; Rosalind P Candelaria; Gildy V Babiera; Basak E Dogan; Lumarie Santiago; Kelly K Hunt; Henry M Kuerer Journal: J Clin Oncol Date: 2016-01-25 Impact factor: 44.544
Authors: Jana de Boniface; Jan Frisell; Yvette Andersson; Leif Bergkvist; Johan Ahlgren; Lisa Rydén; Roger Olofsson Bagge; Malin Sund; Hemming Johansson; Dan Lundstedt Journal: BMC Cancer Date: 2017-05-26 Impact factor: 4.430
Authors: Amit Goyal; G Bruce Mann; Lesley Fallowfield; Lelia Duley; Malcolm Reed; David Dodwell; Robert E Coleman; Apostolos Fakis; Robert Newcombe; Valerie Jenkins; Diane Whitham; Margaret Childs; David Whynes; Vaughan Keeley; Ian Ellis; Patricia Fairbrother; Shabina Sadiq; Kathryn Monson; Alan Montgomery; Wei Tan; Luke Vale; Tara Homer; Heath Badger; Rachel Helen Haines; Mickey Lewis; Daniel Megias; Zohal Nabi; Preetinder Singh; Andrei Caraman; Elizabeth Miles Journal: BMJ Open Date: 2021-12-02 Impact factor: 2.692
Authors: Juan C Vázquez; Antonio Piñero; Francisco J de Castro; Ana Lluch; Miguel Martín; Agustí Barnadas; Emilio Alba; Álvaro Rodríguez-Lescure; Federico Rojo; Julia Giménez; Ivan Solá; Maria J Quintana; Xavier Bonfill; Gerard Urrutia; Pedro Sánchez-Rovira Journal: Clin Transl Oncol Date: 2022-09-25 Impact factor: 3.340