Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up
Identifieur interne : 004498 ( Main/Curation ); précédent : 004497; suivant : 004499Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up
Auteurs : Fausto Petrelli ; Veronica Lonati ; Sandro BarniSource :
- Oncology Reviews [ 1970-5565 ] ; 2012.
Abstract
Sentinel lymph node biopsy is now accepted as the initial approach for women with early stage breast cancer with clinically node-negative disease. We performed a pooled analysis of trials comparing axillary lymph node dissection to sentinel lymph node biopsy in patients with early stage breast cancer and pathologically negative sentinel lymph node analysis. A systematic MEDLINE review identified four randomized trials of axillary dissection
Url:
DOI: 10.4081/oncol.2012.e20
PubMed: 25992218
PubMed Central: 4419626
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<author><name sortKey="Lonati, Veronica" sort="Lonati, Veronica" uniqKey="Lonati V" first="Veronica" last="Lonati">Veronica Lonati</name>
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<series><title level="j">Oncology Reviews</title>
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<front><div type="abstract" xml:lang="en"><p>Sentinel lymph node biopsy is now accepted as the initial approach for women with early stage breast cancer with clinically node-negative disease. We performed a pooled analysis of trials comparing axillary lymph node dissection to sentinel lymph node biopsy in patients with early stage breast cancer and pathologically negative sentinel lymph node analysis. A systematic MEDLINE review identified four randomized trials of axillary dissection <italic>versus</italic>
sentinel lymph node biopsy in lymph node-negative early stage breast cancer patients. A meta-analysis was performed for survival and relapse. The combined analyses of these four trials found no significant difference in overall survival (relative risk [RR] 1.15; P=0.16; 95% CI: 0.95–1.39), breast cancer-specific (RR 1.03; P=0.85; 95% CI: 0.751.43) and disease-free survival (RR 1.07; P=0.3; 95% CI: 0.94–1.21), distant metastases (RR 1; P=0.98; 95% CI: 0.76–1.32), and ipsilateral breast recurrence (RR 1.64; P=0.34; 95% CI: 0.60–4.47) associated with sentinel lymph node biopsy. In particular, a similar rate of nodal recurrences was seen after sentinel lymph node biopsy (RR 1.74; P=0.13; 95% CI: 0.86–3.53). Axillary dissection does not confer a survival benefit nor prevent further nodal relapses in the setting of early stage, pathologically lymph node-negative breast cancer.</p>
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