The Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Initially Clinically Node-Negative Breast Cancer after Neoadjuvant Chemotherapy: A Systematic Review and Meta-AnalysisReport as inadecuate




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 - Download this document for free, or read online. Document in PDF available to download.

Background

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.

Methods

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.

Results

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.

Conclusion

Based on current evidence, SLNB is technically feasible and accurate enough for axillary staging in initially clinically node-negative breast cancer patients after NAC.



Author: Chong Geng, Xiao Chen, Xiaohua Pan, Jiyu Li

Source: http://plos.srce.hr/



DOWNLOAD PDF




Related documents