Axillary treatment for operable primary breast cancer.
Identifieur interne : 000430 ( PubMed/Curation ); précédent : 000429; suivant : 000431Axillary treatment for operable primary breast cancer.
Auteurs : Nathan Bromham ; Mia Schmidt-Hansen ; Margaret Astin ; Elise Hasler ; Malcolm W. ReedSource :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2017.
Descripteurs français
- KwdFr :
- Aisselle, Biopsie de noeud lymphatique sentinelle (), Biopsie de noeud lymphatique sentinelle (effets indésirables), Essais contrôlés randomisés comme sujet, Femelle, Humains, Lymphadénectomie (), Lymphadénectomie (effets indésirables), Lymphoedème (étiologie), Récidive tumorale locale (mortalité), Tumeurs du sein (), Tumeurs du sein (mortalité), Tumeurs du sein (radiothérapie).
- MESH :
- effets indésirables : Biopsie de noeud lymphatique sentinelle, Lymphadénectomie.
- mortalité : Récidive tumorale locale, Tumeurs du sein.
- radiothérapie : Tumeurs du sein.
- étiologie : Lymphoedème.
- Aisselle, Biopsie de noeud lymphatique sentinelle, Essais contrôlés randomisés comme sujet, Femelle, Humains, Lymphadénectomie, Tumeurs du sein.
English descriptors
- KwdEn :
- Axilla, Breast Neoplasms (mortality), Breast Neoplasms (radiotherapy), Breast Neoplasms (surgery), Female, Humans, Lymph Node Excision (adverse effects), Lymph Node Excision (methods), Lymphedema (etiology), Neoplasm Recurrence, Local (mortality), Randomized Controlled Trials as Topic, Sentinel Lymph Node Biopsy (adverse effects), Sentinel Lymph Node Biopsy (methods).
- MESH :
- adverse effects : Lymph Node Excision, Sentinel Lymph Node Biopsy.
- etiology : Lymphedema.
- methods : Lymph Node Excision, Sentinel Lymph Node Biopsy.
- mortality : Breast Neoplasms, Neoplasm Recurrence, Local.
- radiotherapy : Breast Neoplasms.
- surgery : Breast Neoplasms.
- Axilla, Female, Humans, Randomized Controlled Trials as Topic.
Abstract
Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy and potentially local control of axillary disease. Several alternative approaches to axillary surgery are available, most of which aim to spare a proportion of women the morbidity of complete axillary dissection.
DOI: 10.1002/14651858.CD004561.pub3
PubMed: 28052186
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Nathan Bromham<affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation><affiliation><nlm:affiliation>Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK, BS8 2PS.</nlm:affiliation><wicri:noCountry code="subField">BS8 2PS</wicri:noCountry></affiliation><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation><affiliation><nlm:affiliation>Brighton and Sussex Medical School, Universities of Brighton and Sussex, BSMS Teaching Building, Uinversity of Sussex, Falmer, Brighton, East Sussex, UK, BN1 9PX.</nlm:affiliation><wicri:noCountry code="subField">BN1 9PX</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Axillary treatment for operable primary breast cancer.</title><author><name sortKey="Bromham, Nathan" sort="Bromham, Nathan" uniqKey="Bromham N" first="Nathan" last="Bromham">Nathan Bromham</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Schmidt Hansen, Mia" sort="Schmidt Hansen, Mia" uniqKey="Schmidt Hansen M" first="Mia" last="Schmidt-Hansen">Mia Schmidt-Hansen</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Astin, Margaret" sort="Astin, Margaret" uniqKey="Astin M" first="Margaret" last="Astin">Margaret Astin</name><affiliation><nlm:affiliation>Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK, BS8 2PS.</nlm:affiliation><wicri:noCountry code="subField">BS8 2PS</wicri:noCountry></affiliation></author><author><name sortKey="Hasler, Elise" sort="Hasler, Elise" uniqKey="Hasler E" first="Elise" last="Hasler">Elise Hasler</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Reed, Malcolm W" sort="Reed, Malcolm W" uniqKey="Reed M" first="Malcolm W" last="Reed">Malcolm W. Reed</name><affiliation><nlm:affiliation>Brighton and Sussex Medical School, Universities of Brighton and Sussex, BSMS Teaching Building, Uinversity of Sussex, Falmer, Brighton, East Sussex, UK, BN1 9PX.</nlm:affiliation><wicri:noCountry code="subField">BN1 9PX</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28052186</idno><idno type="pmid">28052186</idno><idno type="doi">10.1002/14651858.CD004561.pub3</idno><idno type="wicri:Area/PubMed/Corpus">000430</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000430</idno><idno type="wicri:Area/PubMed/Curation">000430</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000430</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Axillary treatment for operable primary breast cancer.</title><author><name sortKey="Bromham, Nathan" sort="Bromham, Nathan" uniqKey="Bromham N" first="Nathan" last="Bromham">Nathan Bromham</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Schmidt Hansen, Mia" sort="Schmidt Hansen, Mia" uniqKey="Schmidt Hansen M" first="Mia" last="Schmidt-Hansen">Mia Schmidt-Hansen</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Astin, Margaret" sort="Astin, Margaret" uniqKey="Astin M" first="Margaret" last="Astin">Margaret Astin</name><affiliation><nlm:affiliation>Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK, BS8 2PS.</nlm:affiliation><wicri:noCountry code="subField">BS8 2PS</wicri:noCountry></affiliation></author><author><name sortKey="Hasler, Elise" sort="Hasler, Elise" uniqKey="Hasler E" first="Elise" last="Hasler">Elise Hasler</name><affiliation><nlm:affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</nlm:affiliation><wicri:noCountry code="subField">NW1 4RG</wicri:noCountry></affiliation></author><author><name sortKey="Reed, Malcolm W" sort="Reed, Malcolm W" uniqKey="Reed M" first="Malcolm W" last="Reed">Malcolm W. Reed</name><affiliation><nlm:affiliation>Brighton and Sussex Medical School, Universities of Brighton and Sussex, BSMS Teaching Building, Uinversity of Sussex, Falmer, Brighton, East Sussex, UK, BN1 9PX.</nlm:affiliation><wicri:noCountry code="subField">BN1 9PX</wicri:noCountry></affiliation></author></analytic><series><title level="j">The Cochrane database of systematic reviews</title><idno type="eISSN">1469-493X</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms (mortality)</term><term>Breast Neoplasms (radiotherapy)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymph Node Excision (methods)</term><term>Lymphedema (etiology)</term><term>Neoplasm Recurrence, Local (mortality)</term><term>Randomized Controlled Trials as Topic</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term><term>Sentinel Lymph Node Biopsy (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle ()</term><term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term><term>Essais contrôlés randomisés comme sujet</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie ()</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème (étiologie)</term><term>Récidive tumorale locale (mortalité)</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (mortalité)</term><term>Tumeurs du sein (radiothérapie)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Breast Neoplasms</term><term>Neoplasm Recurrence, Local</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Récidive tumorale locale</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Female</term><term>Humans</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Essais contrôlés randomisés comme sujet</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy and potentially local control of axillary disease. Several alternative approaches to axillary surgery are available, most of which aim to spare a proportion of women the morbidity of complete axillary dissection.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28052186</PMID><DateCreated><Year>2017</Year><Month>01</Month><Day>04</Day></DateCreated><DateCompleted><Year>2017</Year><Month>04</Month><Day>26</Day></DateCompleted><DateRevised><Year>2017</Year><Month>04</Month><Day>26</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1469-493X</ISSN><JournalIssue CitedMedium="Internet"><Volume>1</Volume><PubDate><Year>2017</Year><Month>01</Month><Day>04</Day></PubDate></JournalIssue><Title>The Cochrane database of systematic reviews</Title><ISOAbbreviation>Cochrane Database Syst Rev</ISOAbbreviation></Journal><ArticleTitle>Axillary treatment for operable primary breast cancer.</ArticleTitle><Pagination><MedlinePgn>CD004561</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/14651858.CD004561.pub3</ELocationID><Abstract><AbstractText Label="BACKGROUND">Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy and potentially local control of axillary disease. Several alternative approaches to axillary surgery are available, most of which aim to spare a proportion of women the morbidity of complete axillary dissection.</AbstractText><AbstractText Label="OBJECTIVES">To assess the benefits and harms of alternative approaches to axillary surgery (including omitting such surgery altogether) in terms of overall survival; local, regional and distant recurrences; and adverse events.</AbstractText><AbstractText Label="SEARCH METHODS">We searched the Cochrane Breast Cancer Group Specialised Register, MEDLINE, Pre-MEDLINE, Embase, CENTRAL, the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov on 12 March 2015 without language restrictions. We also contacted study authors and checked reference lists.</AbstractText><AbstractText Label="SELECTION CRITERIA">Randomised controlled trials (RCTs) including women with clinically defined operable primary breast cancer conducted to compare axillary lymph node dissection (ALND) with no axillary surgery, axillary sampling or sentinel lymph node biopsy (SLNB); RCTs comparing axillary sampling with SLNB or no axillary surgery; RCTs comparing SLNB with no axillary surgery; and RCTs comparing ALND with or without radiotherapy (RT) versus RT alone.</AbstractText><AbstractText Label="DATA COLLECTION AND ANALYSIS">Two review authors independently assessed each potentially relevant trial for inclusion. We independently extracted outcome data, risk of bias information and study characteristics from all included trials. We pooled data according to trial interventions, and we used hazard ratios (HRs) for time-to-event outcomes and odds ratios (OR) for binary outcomes.</AbstractText><AbstractText Label="MAIN RESULTS">We included 26 RCTs in this review. Studies were at low or unclear risk of selection bias. Blinding was not done, but this was only considered a source of bias for outcomes with potential for subjectivity in measurements. We found no RCTs of axillary sampling versus SLNB, axillary sampling versus no axillary surgery or SLNB versus no axillary surgery. No axillary surgery versus ALND Ten trials involving 3849 participants compared no axillary surgery versus ALND. Moderate quality evidence showed no important differences between overall survival of women in the two groups (HR 1.06, 95% confidence interval (CI) 0.96 to 1.17; 3849 participants; 10 studies) although no axillary surgery increased the risk of locoregional recurrence (HR ranging from 1.10 to 3.06; 20,863 person-years of follow-up; four studies). It was uncertain whether no surgery increased the risk of distant metastasis compared with ALND (HR 1.06, 95% CI 0.87 to 1.30; 946 participants; two studies). Low-quality evidence indicated no axillary surgery decreased the risk of lymphoedema compared with ALND (OR 0.31, 95% CI 0.23 to 0.43; 1714 participants; four studies). Axillary sampling versus ALND Six trials involving 1559 participants compared axillary sampling versus ALND. Low-quality evidence indicated similar effectiveness of axillary sampling compared with ALND in terms of overall survival (HR 0.94, 95% CI 0.73 to 1.21; 967 participants; three studies) but it was unclear whether axillary sampling led to increased risk of local recurrence compared with ALND (HR 1.41, 95% CI 0.94 to 2.12; 1404 participants; three studies). The relative effectiveness of axillary sampling and ALND for locoregional recurrence (HR 0.74, 95% CI 0.46 to 1.20; 406 participants; one study) and distant metastasis was uncertain (HR 1.05, 95% CI 0.74 to 1.49; 406 participants; one study). Lymphoedema was less likely after axillary sampling than after ALND (OR 0.32, 95% CI 0.13 to 0.81; 80 participants; one study). SLNB versus ALND Seven trials involving 9426 participants compared SLNB with ALND. Moderate-quality evidence showed similar overall survival following SLNB compared with ALND (HR 1.05, 95% CI 0.89 to 1.25; 6352 participants; three studies; moderate-quality evidence). Differences in local recurrence (HR 0.94, 95% CI 0.24 to 3.77; 516 participants; one study), locoregional recurrence (HR 0.96, 95% CI 0.74 to 1.24; 5611 participants; one study) and distant metastasis (HR 0.80, 95% CI 0.42 to 1.53; 516 participants; one study) were uncertain. However, studies showed little absolute difference in the aforementioned outcomes. Lymphoedema was less likely after SLNB than ALND (OR ranged from 0.04 to 0.60; three studies; 1965 participants; low-quality evidence). Three studies including 1755 participants reported quality of life: Investigators in two studies found quality of life better after SLNB than ALND, and in the other study observed no difference. RT versus ALND Four trials involving 2585 participants compared RT alone with ALND (with or without RT). High-quality evidence indicated that overall survival was reduced among women treated with radiotherapy alone compared with those treated with ALND (HR 1.10, 95% CI 1.00 to 1.21; 2469 participants; four studies), and local recurrence was less likely in women treated with radiotherapy than in those treated with ALND (HR 0.80, 95% CI 0.64 to 0.99; 22,256 person-years of follow-up; four studies). Risk of distant metastasis was similar for radiotherapy alone as for ALND (HR 1.07, 95% CI 0.93 to 1.25; 1313 participants; one study), and whether lymphoedema was less likely after RT alone than ALND remained uncertain (OR 0.47, 95% CI 0.16 to 1.44; 200 participants; one study). Less surgery versus ALND When combining results from all trials, treatment involving less surgery was associated with reduced overall survival compared with ALND (HR 1.08, 95% CI 1.01 to 1.17; 6478 participants; 18 studies). Whether local recurrence was reduced with less axillary surgery when compared with ALND was uncertain (HR 0.90, 95% CI 0.75 to 1.09; 24,176 participant-years of follow up; eight studies). Locoregional recurrence was more likely with less surgery than with ALND (HR 1.53, 95% CI 1.31 to 1.78; 26,880 participant-years of follow-up; seven studies). Whether risk of distant metastasis was increased after less axillary surgery compared with ALND was uncertain (HR 1.07, 95% CI 0.95 to 1.20; 2665 participants; five studies). Lymphoedema was less likely after less axillary surgery than with ALND (OR 0.37, 95% CI 0.29 to 0.46; 3964 participants; nine studies).No studies reported on disease control in the axilla.</AbstractText><AbstractText Label="AUTHORS' CONCLUSIONS">This review confirms the benefit of SLNB and axillary sampling as alternatives to ALND for axillary staging, supporting the view that ALND of the clinically and radiologically uninvolved axilla is no longer acceptable practice in people with breast cancer.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bromham</LastName><ForeName>Nathan</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schmidt-Hansen</LastName><ForeName>Mia</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Astin</LastName><ForeName>Margaret</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK, BS8 2PS.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hasler</LastName><ForeName>Elise</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regents Park, London, England, UK, NW1 4RG.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reed</LastName><ForeName>Malcolm W</ForeName><Initials>MW</Initials><AffiliationInfo><Affiliation>Brighton and Sussex Medical School, Universities of Brighton and Sussex, BSMS Teaching Building, Uinversity of Sussex, Falmer, Brighton, East Sussex, UK, BN1 9PX.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>01</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Cochrane Database Syst Rev</MedlineTA><NlmUniqueID>100909747</NlmUniqueID><ISSNLinking>1361-6137</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000532" MajorTopicYN="N">radiotherapy</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009364" MajorTopicYN="N">Neoplasm Recurrence, Local</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D021701" MajorTopicYN="N">Sentinel Lymph Node Biopsy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>1</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>4</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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