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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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Should internal mammary lymph node sentinel biopsy be performed in breast cancer : a systematic review and meta-analysis. / Gong, Jing; Yu, Yongfu; Wu, Gaosong; Lin, Congyao; Tu, Xin.
In: World Journal of Surgical Oncology, Vol. 17, No. 1, 135, 05.08.2019.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Review › Research › peer-review
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TY - JOUR
T1 - Should internal mammary lymph node sentinel biopsy be performed in breast cancer
T2 - a systematic review and meta-analysis
AU - Gong, Jing
AU - Yu, Yongfu
AU - Wu, Gaosong
AU - Lin, Congyao
AU - Tu, Xin
PY - 2019/8/5
Y1 - 2019/8/5
N2 - 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.
AB - 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.
KW - Breast Neoplasms
KW - Breast cancer
KW - Internal mammary lymph node
KW - Lymphatic metastasis
KW - Meta-analysis
KW - Sentinel lymph node biopsy
KW - Systematic review
U2 - 10.1186/s12957-019-1683-8
DO - 10.1186/s12957-019-1683-8
M3 - Review
C2 - 31382973
VL - 17
JO - World Journal of Surgical Oncology
JF - World Journal of Surgical Oncology
SN - 1477-7819
IS - 1
M1 - 135
ER -