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Should internal mammary lymph node sentinel biopsy be performed in breast cancer: a systematic review and meta-analysis

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  • Jing Gong, Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, 169 DongHu Road, Wuhan, 430071, People's Republic of China.
  • ,
  • Yongfu Yu
  • Gaosong Wu, Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, 169 DongHu Road, Wuhan, 430071, People's Republic of China.
  • ,
  • Congyao Lin, Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, 169 DongHu Road, Wuhan, 430071, People's Republic of China. lincongyao@znhospital.cn.
  • ,
  • Xin Tu, School of Mechanical Engineering and Electronic Information, China University of Geosciences, 388 Lumo Road, Wuhan, 430074, People's Republic of China.

PURPOSE: Results from studies of internal mammary lymph node sentinel biopsy are inconsistent.

METHODS: A comprehensive literature search was conducted in MEDLINE, EMBASE, Scopus, Cochrane database, and Clinical Trials. Studies reporting the rate of internal mammary lymph node sentinel biopsy (IMN-SLNB) positivity were identified. We performed pooled proportion meta-analysis using random-effects meta-analyses. The correlation of IMN and axillary lymph node (AXN) metastasis was also investigated.

RESULTS: After application of inclusion and exclusion criteria, a total of 18 articles (total number of patients = 2427) were included. The pooled estimate for IMN-SLNB positivity rate was 15% (95% confidence interval (CI) 12-17%). Significant between-study heterogeneity was observed. Our results indicate that axillary lymph node metastasis is a strong predictor of IMN involvement (OR 6.01, 95% CI, 3.49, 10.34).

CONCLUSION: Internal mammary lymph nodes metastasis might be underestimated. Patients with positive axillary lymph nodes have a higher risk of internal lymph nodes metastasis. As a result, IMN-SLNB might be considered in these patients. Future work needs to be done to assess whether pathological confirmed IMN metastasis can affect patients' survival.

Original languageEnglish
Article number135
JournalWorld Journal of Surgical Oncology
Volume17
Issue1
Number of pages8
ISSN1477-7819
DOIs
Publication statusPublished - 5 Aug 2019

    Research areas

  • Breast Neoplasms, Breast cancer, Internal mammary lymph node, Lymphatic metastasis, Meta-analysis, Sentinel lymph node biopsy, Systematic review

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