Juan C Vázquez1, Antonio Piñero2, Francisco J de Castro3, Ana Lluch4, Miguel Martín5, Agustí Barnadas6, Emilio Alba7, Álvaro Rodríguez-Lescure8, Federico Rojo9, Julia Giménez10, Ivan Solá11, Maria J Quintana12, 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. GEICAM Spanish Breast Cancer Group, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain. 3. Complejo Asistencial de Salamanca, GEICAM Spanish Breast Cancer Group, Salamanca, Spain. 4. Medical Oncology Unit, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Biomedical Research Institute INCLIVA, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain. 5. Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Universidad Complutense de Madrid, Madrid, Spain. 6. Medical Oncology Unit, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain. 7. Centro de Investigación Biomédica en Red de Oncología, GEICAM Spanish Breast Cancer Group, UGCI Oncología Médica, Hospitales Regional y Virgen de la Victoria, IBIMA, CIBERONC-ISCIII, Málaga, Spain. 8. GEICAM Spanish Breast Cancer Group, Hospital General Universitario de Elche, Alicante, Spain. 9. Centro de Investigación Biomédica en Red de Oncología, GEICAM Spanish Breast Cancer Group, Hospital Universitario Fundacion Jimenez Diaz, CIBERONC-ISCIII, 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, GEICAM Spanish Breast Cancer Group, Complejo Hospitalario de Jaén, Jaén, Spain.
Abstract
PURPOSE: To conduct a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy, compared to axillary lymph-node dissection. METHODS: The more relevant databases were searched. Main outcomes were false-negative rate (FNR), sentinel lymph-node identification rate (SLNIR), negative predictive value (NPV), and accuracy. We conducted meta-analyses when appropriate. RESULTS: Twenty studies were included. The pooled FNR was 0.14 (95% CI 0.11-0.17), the pooled SLNIR was 0.89 (95% CI 0.86-0.92), NPV was 0.83 (95% CI 0.79-0.87), and summary accuracy was 0.92 (95% CI 0.90-0.94). SLNB performed better when more than one node was removed and double mapping was used. CONCLUSIONS: SLNB can be performed in women with a node-negative tumour after neoadjuvant therapy. It has a better performance when used with previous marking of the affected node and with double tracer.
PURPOSE: To conduct a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy, compared to axillary lymph-node dissection. METHODS: The more relevant databases were searched. Main outcomes were false-negative rate (FNR), sentinel lymph-node identification rate (SLNIR), negative predictive value (NPV), and accuracy. We conducted meta-analyses when appropriate. RESULTS: Twenty studies were included. The pooled FNR was 0.14 (95% CI 0.11-0.17), the pooled SLNIR was 0.89 (95% CI 0.86-0.92), NPV was 0.83 (95% CI 0.79-0.87), and summary accuracy was 0.92 (95% CI 0.90-0.94). SLNB performed better when more than one node was removed and double mapping was used. CONCLUSIONS: SLNB can be performed in women with a node-negative tumour after neoadjuvant therapy. It has a better performance when used with previous marking of the affected node and with double tracer.
Authors: Gordon H Guyatt; Andrew D Oxman; Holger J Schünemann; Peter Tugwell; Andre Knottnerus Journal: J Clin Epidemiol Date: 2010-12-24 Impact factor: 6.437
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