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SpringerPlus Journal Axillary Surgery 2016.pdf (2.02 MB)

Axillary surgery in women with sentinel node-positive operable breast cancer: a systematic review with meta-analyses

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posted on 2023-06-09, 00:53 authored by Mia Schmidt-Hansen, Nathan Bromham, Elise Hasler, Malcolm ReedMalcolm Reed
Traditionally, women with node-positive operable breast cancer have received complete axillary lymph node dissection (ALND), which is associated with significant morbidity, but recently less invasive alternatives have been explored. We conducted a systematic review of randomised controlled trials assessing alternative approaches to axillary surgery in patients with pathologically-confirmed sentinel node-positive operable breast cancer. We searched on 16/3/15 the Specialized Register of the Cochrane Breast Cancer group; CENTRAL; MEDLINE; PreMEDLINE; EMBASE; WHO International Clinical Trials Registry Portal; ClinicalTrials.gov; conference proceedings from ASCO and the San Antonio Breast Cancer meetings; checked reference lists and contacted authors to identify relevant studies. Double, independent study sifting, extraction, appraisal and summarising were undertaken using standard Cochrane Collaboration methodology. We included three studies (2020 patients) comparing ALND with sentinel lymph node dissection (SLND) to SLND alone, and two studies (1899 patients) comparing ALND to axillary radiotherapy (aRT). No differences in survival or recurrence were observed between ALND and SLND or aRT, but morbidity may have been increased in ALND, and all the results were subject to different biases, such as recruitment bias, performance bias, and outcome-reporting bias. Whilst it is encouraging that there appears to be no adverse effect on recurrence or survival, it will be appropriate to confirm these findings and provide additional data confirming quality of life effects and long term outcomes.

History

Publication status

  • Published

File Version

  • Published version

Journal

SpringerPlus

ISSN

2193-1801

Publisher

Springer International Publishing

Issue

85

Volume

5

Department affiliated with

  • BSMS Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2016-04-15

First Open Access (FOA) Date

2016-04-15

First Compliant Deposit (FCD) Date

2016-04-15

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