The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis
Identifieur interne : 000A54 ( Main/Exploration ); précédent : 000A53; suivant : 000A55The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis
Auteurs : Chong Geng ; Xiao Chen ; Xiaohua Pan ; Jiyu LiSource :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
With the increased use of neoadjuvant chemotherapy (NAC) in breast cancer, the timing of sentinel lymph node biopsy (SLNB) has become increasingly important. In this study, we aimed to evaluate the feasibility and accuracy of SLNB for initially clinically node-negative breast cancer after NAC by conducting a systematic review and meta-analysis.
We searched PubMed, Embase, and the Cochrane Library from January 1, 1993 to November 30, 2015 for studies on initially clinically node-negative breast cancer patients who underwent SLNB after NAC followed by axillary lymph node dissection (ALND).
A total of 1,456 patients from 16 studies were included in this review. The pooled identification rate (IR) for SLNB was 96% [95% confidence interval (CI): 95%-97%], and the false negative rate (FNR) was 6% (95% CI: 3%-8%). The pooled sensitivity, negative predictive value (NPV) and accuracy rate (AR) were 94% (95% CI: 92%-97%, I2 = 27.5%), 98% (95% CI: 98%-99%, I2 = 42.7%) and 99% (95% CI: 99%-100%, I2 = 32.6%), respectively. In the subgroup analysis, no significant differences were found in either the IR of an SLNB when different mapping methods were used (P = 0.180) or in the FNR between studies with and without immunohistochemistry (IHC) staining (P = 0.241).
Based on current evidence, SLNB is technically feasible and accurate enough for axillary staging in initially clinically node-negative breast cancer patients after NAC.
Url:
DOI: 10.1371/journal.pone.0162605
PubMed: 27606623
PubMed Central: 5015960
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis</title><author><name sortKey="Geng, Chong" sort="Geng, Chong" uniqKey="Geng C" first="Chong" last="Geng">Chong Geng</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Xiao" sort="Chen, Xiao" uniqKey="Chen X" first="Xiao" last="Chen">Xiao Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Pan, Xiaohua" sort="Pan, Xiaohua" uniqKey="Pan X" first="Xiaohua" last="Pan">Xiaohua Pan</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Li, Jiyu" sort="Li, Jiyu" uniqKey="Li J" first="Jiyu" last="Li">Jiyu Li</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27606623</idno><idno type="pmc">5015960</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015960</idno><idno type="RBID">PMC:5015960</idno><idno type="doi">10.1371/journal.pone.0162605</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">004406</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004406</idno><idno type="wicri:Area/Pmc/Curation">004405</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004405</idno><idno type="wicri:Area/Pmc/Checkpoint">000555</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000555</idno><idno type="wicri:Area/Ncbi/Merge">008780</idno><idno type="wicri:Area/Ncbi/Curation">008780</idno><idno type="wicri:Area/Ncbi/Checkpoint">008780</idno><idno type="wicri:Area/Main/Merge">000A55</idno><idno type="wicri:Area/Main/Curation">000A54</idno><idno type="wicri:Area/Main/Exploration">000A54</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis</title><author><name sortKey="Geng, Chong" sort="Geng, Chong" uniqKey="Geng C" first="Chong" last="Geng">Chong Geng</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Chen, Xiao" sort="Chen, Xiao" uniqKey="Chen X" first="Xiao" last="Chen">Xiao Chen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Pan, Xiaohua" sort="Pan, Xiaohua" uniqKey="Pan X" first="Xiaohua" last="Pan">Xiaohua Pan</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Li, Jiyu" sort="Li, Jiyu" uniqKey="Li J" first="Jiyu" last="Li">Jiyu Li</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>With the increased use of neoadjuvant chemotherapy (NAC) in breast cancer, the timing of sentinel lymph node biopsy (SLNB) has become increasingly important. In this study, we aimed to evaluate the feasibility and accuracy of SLNB for initially clinically node-negative breast cancer after NAC by conducting a systematic review and meta-analysis.</p></sec><sec id="sec002"><title>Methods</title><p>We searched PubMed, Embase, and the Cochrane Library from January 1, 1993 to November 30, 2015 for studies on initially clinically node-negative breast cancer patients who underwent SLNB after NAC followed by axillary lymph node dissection (ALND).</p></sec><sec id="sec003"><title>Results</title><p>A total of 1,456 patients from 16 studies were included in this review. The pooled identification rate (IR) for SLNB was 96% [95% confidence interval (CI): 95%-97%], and the false negative rate (FNR) was 6% (95% CI: 3%-8%). The pooled sensitivity, negative predictive value (NPV) and accuracy rate (AR) were 94% (95% CI: 92%-97%, I<sup>2</sup> = 27.5%), 98% (95% CI: 98%-99%, I<sup>2</sup> = 42.7%) and 99% (95% CI: 99%-100%, I<sup>2</sup> = 32.6%), respectively. In the subgroup analysis, no significant differences were found in either the IR of an SLNB when different mapping methods were used (P = 0.180) or in the FNR between studies with and without immunohistochemistry (IHC) staining (P = 0.241).</p></sec><sec id="sec004"><title>Conclusion</title><p>Based on current evidence, SLNB is technically feasible and accurate enough for axillary staging in initially clinically node-negative breast cancer patients after NAC.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Samphao, S" uniqKey="Samphao S">S Samphao</name></author><author><name sortKey="Eremin, Jm" uniqKey="Eremin J">JM Eremin</name></author><author><name sortKey="El Sheemy, M" uniqKey="El Sheemy M">M El-Sheemy</name></author><author><name sortKey="Eremin, O" uniqKey="Eremin O">O Eremin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Botteri, E" uniqKey="Botteri E">E 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sortKey="Giuliano, R" uniqKey="Giuliano R">R Giuliano</name></author><author><name sortKey="Dauway, El" uniqKey="Dauway E">EL Dauway</name></author><author><name sortKey="Cantor, A" uniqKey="Cantor A">A Cantor</name></author><author><name sortKey="Berman, C" uniqKey="Berman C">C Berman</name></author><author><name sortKey="Ku, Nn" uniqKey="Ku N">NN Ku</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Chen, Xiao" sort="Chen, Xiao" uniqKey="Chen X" first="Xiao" last="Chen">Xiao Chen</name><name sortKey="Geng, Chong" sort="Geng, Chong" uniqKey="Geng C" first="Chong" last="Geng">Chong Geng</name><name sortKey="Li, Jiyu" sort="Li, Jiyu" uniqKey="Li J" first="Jiyu" last="Li">Jiyu Li</name><name sortKey="Pan, Xiaohua" sort="Pan, Xiaohua" uniqKey="Pan X" first="Xiaohua" last="Pan">Xiaohua Pan</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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