A nonrandomized follow-up comparison between standard axillary node dissection and sentinel node biopsy in breast cancer

Kempler, Péter; Schrenk, Peter; Reitsamer, Roland; Koeberle-Wuehrer, Roswitha; Tausch, Christoph; Roka, R.; Riedl, O; Poestlberger, S.; Hecke, D.; Janauer, M; Haid, A.

doi:10.1016/j.breast.2007.04.001

Cited by 14 publications

(7 citation statements)

References 25 publications

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“…Compared with ALND, SLNB has been demonstrated to reduce unnecessary complications and improve the quality of life of patients [9,10]. Additionally, it is reported that regional recurrence and overall survival were equivalent between SLNB and ALND in patients with clinically node-negative breast cancer [11]. Consequently, many institutions have accepted SLNB as the standard performance for patients with negative SLNs.…”

Section: Introductionmentioning

confidence: 97%

Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

Wang

Chen

2011

Breast Cancer Res Treat

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Sentinel lymph node biopsy (SLNB) has been recommended as the standard performance for negative sentinel lymph node (SLN) patients without axillary lymph node dissection (ALND) in the surgical management of early breast cancer; however, the efficiency of SLNB for patients with positive SLNs is still unclear. We performed this meta-analysis to compare the effectiveness and safety of SLNB with ALND. Randomized controlled trials (RCTs) comparing SLNB with ALND in early breast cancer were identified in Pubmed, Embase, and The Cochrane Library. Overall survival (OS), disease-free survival (DFS), regional lymph node recurrence, postoperative morbidity, and quality of life (QOL) between the two groups were assessed by using the methods provided by the Cochrane Handbook for Systematic Reviews of Interventions. Eight well-designed RCTs (total 8,560 patients; 4,301 for SLNB and 4,259 for ALND) were included. Meta-analysis showed that there was no statistical difference in OS (HR = 1.07, 95% CI: 0.90-1.27), DFS (HR = 1.00, 95% CI: 0.88-1.14), and regional lymph node recurrence (OR = 1.65, 95% CI: 0.77-3.56) between SLNB and ALND group, whether for SLN (+) subgroup or for SLN (-) subgroup. However, SLNB results in a significant reduction of postoperative morbidity and improved QOL. In conclusion, SLNB can be recommended as preferred care for SLN-negative patients and selected patients with SLN-micrometastasis. Despite this, ALND remains the standard management in breast cancer patients with SLN-macrometastasis.

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Section: Introductionmentioning

confidence: 97%

Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

Wang

Chen

2011

Breast Cancer Res Treat

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“…Several studies show that radical breast dissection is only called for when SLNs contain metastatic tumour cells, sparing many breast cancer patients disfiguring surgery (e.g. [12]; reviewed in [13]). Interestingly, there is a rising incidence of breast carcinomas with micrometastatic lymph node involvement, possibly associated with the increased use of sentinel node biopsy [14].…”

Section: Introduction: Clinical Significance Of Lymphatic Metastases mentioning

confidence: 99%

Lymphatic metastasis in breast cancer: importance and new insights into cellular and molecular mechanisms

Eccles

Paon

Sleeman

2007

Clin Exp Metastasis

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Lymph node metastasis is the main prognosis factor in a number of malignancies, including breast carcinomas. The means by which lymph node metastases arise is not fully understood, and many questions remain about their importance in the further spread of breast cancer. Nevertheless, a number of key cellular and molecular mechanisms of lymphatic metastasis have been identified. These include induction of intra- or peri-tumoral lymphangiogenesis or co-option of existing lymphatic vessels to allow tumour cells to enter the lymphatics, although it remains to be established whether this is primarily an active or passive process. Gene expression microarrays and functional studies in vitro and in vivo, together with detailed clinical observations have identified a number of molecules that can play a role in the genesis of lymph node metastases. These include the well-recognised lymphangiogenic cytokines VEGF-C and VEGF-D as well as chemokine-receptor interactions, integrins and downstream signalling pathways. This paper briefly reviews current clinical and experimental evidence for the underlying mechanisms and significance of lymphatic metastasis in breast cancer and highlights questions that still need to be addressed.

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“…The aim of the detection of the SLN is to reduce postoperative morbidity resulting from axillary lymphadenectomy and maintain the correct staging of axilla in breast cancer. Studies which analysed the disease remaining after SLN suggest that this is an efficient method in breast cancer (Konstantiniuk et al, 2007;Janssen et al, 2004). One of the main complications after surgical treatment is upper limb lymphedema.…”

Section: Resultsmentioning

confidence: 99%

Lymphoscintigraphy in breast cancer: a short review about the impact on upper limb after surgical treatment

Bergmann

Resende

Santos-Filho

et al. 2008

Braz. arch. biol. technol.

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A nonrandomized follow-up comparison between standard axillary node dissection and sentinel node biopsy in breast cancer

Cited by 14 publications

References 25 publications

Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

Lymphatic metastasis in breast cancer: importance and new insights into cellular and molecular mechanisms

Lymphoscintigraphy in breast cancer: a short review about the impact on upper limb after surgical treatment

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