Axillary lymph node dissection versus sentinel lymph node biopsy alone for early breast cancer with sentinel node metastasis: A meta-analysis

Li, C.Z.; Zhang, P.; Li, R.W.; Wu, Chih Yang; Zhang, X.P.; Zhu, Hancheng

doi:10.1016/j.ejso.2015.05.007

Cited by 63 publications

(50 citation statements)

References 45 publications

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“…The studies cited above show that supplementary ALND with one or two positive SNs does not offer any therapeutic advantage. This has been confirmed by Li et al recently in a meta-analysis of 12 studies including a total of 130 575 patients [24]. In comparison with SNB alone, supplementary ALND showed no therapeutic benefit.…”

Section: Radiotherapy Of the Internal Mammary Nodes (Imns)mentioning

confidence: 58%

Radiotherapy of the lymphatic drainage pathways in breast carcinoma: time for a reassessment

Piroth

Sautter-Bihl

Baumann

et al. 2017

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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Background The treatment administered for regional lymph nodes has altered dramatically in recent years. The state of the evidence on radiotherapy has also substantially improved and a reassessment is required. Materials and results Randomized studies are available on axillary surgery versus radiotherapy (AMAROS); on refraining from axillary dissection after a positive sentinel node (SN) when radiotherapy is planned (ACOSOG Z0011); and on adjuvant radiotherapy of the regional lymph nodes (LNs). ACOSOG Z0011 shows that refraining from axillary dissection is possible even when there are one or two positive SNs. The meta-analysis of the studies on adjuvant radiotherapy for the regional LNs (EORTC, Canadian, and French studies) shows a significant survival benefit with radiotherapy, and a Danish cohort study has confirmed this result. The reduction in breast cancer–specific mortality in these studies was partly based on a “systemic” effect of regional radiotherapy, with a reduction in the rate of distant metastases. Conclusions The principle applying in surgical treatment of the axilla is “less is not worse.” By contrast, the principle applying in radiotherapy of the regional lymph nodes is “more may be better in some circumstances.” There is as yet no clear explanation for the discrepancy between these two findings. An immunological effect (through immunogenic cell death due to irradiation) has been discussed. Further research is needed on which patients are today capable of benefiting from regional radiotherapy.

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Section: Radiotherapy Of the Internal Mammary Nodes (Imns)mentioning

confidence: 58%

Radiotherapy of the lymphatic drainage pathways in breast carcinoma: time for a reassessment

Piroth

Sautter-Bihl

Baumann

et al. 2017

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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“…But the method of priority is still surgery [1,2,10,12]. All these in total cause progressing of post mastectomy syndrome (PMS).…”

mentioning

confidence: 99%

“…Mean age of the tested was accordingly 55,44±1,06 and 55,60±1,14 years. Testing of movement's amplitude in shoulder joint, swelling of upper limb and strength of hand flexors' muscles took place on 2 nd day after surgery and at the end of rehabilitation stationary stage (12)(13)(14) th day).…”

mentioning

confidence: 99%

Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

Briskin

Odinets

2015

PPS

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Abstract. Purpose: to determine effectiveness of problem-oriented program of women's physical rehabilitation with post mastectomy syndrome in improvement of upper limb's functional state. Material: 50 women with early symptoms of post mastectomy syndrome at stationary rehabilitation stage, who underwent radical mastectomy by Madden were involved in the research. Testing of movement amplitude in shoulder joint, swelling of upper limb and muscular strength of hand's flexors was conducted on 2 nd day after surgery and at the end of stationary rehabilitation period (12-14 th day). Results: Main means of the authors' program were: general and special physical exercises; static and dynamic breathing exercises; breathing through preloaded lips, controlled coughing, autogenic drainage, manual pressing, manual vibration; post-isometric relaxation; elements of labor therapy; lymphatic drainage massage and self massage; topical talks; consultations; auto training. The trainings were conducted individually 2-3 times a day; 20-30 minutes every session. The patients' independent trainings included: fulfillment of therapeutic positions, self-massage, relaxation exercises and auto-training. Conclusions: application of problem-oriented physical rehabilitation program facilitates improvement of upper limb's functional potentials of women with post mastectomy syndrome.

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“…2 The metaanalysis by Li et al published in this issue explores the evolving indications for axillary surgery by examining both retrospective and prospective studies comparing ALND vs. SLNB alone for axillary nodal disease in SLN-positive early stage breast cancer. 3 The current arguments for performing completion ALND after identification of a positive SLN are twofold. The first is to allow more accurate staging, prognostication and tailoring of therapy.…”

mentioning

confidence: 99%

“…As Li et al describe in their meta-analysis, a number of retrospective single institution series have reported on the outcome of patients who have had SLNB alone for node-positive disease with no difference in local recurrence or overall survival. 3 Most studies report a regional recurrence rate of <2%. A 2009 report using the National Breast Cancer Database (NCDB) also reported an axillary recurrence rate of 1%, and failed to identify a statistically significant difference in these endpoints in 16,000 women with nodal macrometastases treated with SLNB alone after 63 month follow up.…”

mentioning

confidence: 99%

Axillary lymph node dissection for breast cancer: Primum non nocere

Lizarraga¹,

Weigel²

2015

European Journal of Surgical Oncology (EJSO)

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Axillary lymph node dissection versus sentinel lymph node biopsy alone for early breast cancer with sentinel node metastasis: A meta-analysis

Cited by 63 publications

References 45 publications

Radiotherapy of the lymphatic drainage pathways in breast carcinoma: time for a reassessment

Radiotherapy of the lymphatic drainage pathways in breast carcinoma: time for a reassessment

Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

Axillary lymph node dissection for breast cancer: Primum non nocere

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