Sentinel lymph node biopsy in patients with microinvasive breast cancer: a systematic review and meta-analysis

Eur J Surg Oncol. 2014 Jan;40(1):5-11. doi: 10.1016/j.ejso.2013.10.020. Epub 2013 Nov 5.

Abstract

Background: The aim of this meta-analysis is to evaluate the role of sentinel lymph node biopsy (SLNB) in patients with microinvasive breast cancer.

Methods: We searched MEDLINE and ISI Web of Science to identify studies including patients with microinvasive breast cancer who underwent SLNB and reported the rate of sentinel-node positivity. We performed proportion meta-analysis using either fixed or random-effects model based on the between-study heterogeneity.

Findings: A total of 24 studies including 968 patients met the eligibility criteria. The summary estimate for the sentinel-node (SN) positivity rate was 3.2% (95% Confidence Interval (CI): 2.1%-4.6%), 4.0% (95% CI 2.7%-5.5%), and 2.9% (95% CI: 1.6%-4.6%) for macrometastasis, micrometastasis and isolated tumor cells (ITC) respectively. Significant between-study heterogeneity was observed only in the meta-analysis of ITC positivity rate.

Interpretation: The amount of positive sentinel node in patients with proven microinvasive breast cancer is relatively low. As a result, the indications for SLNB in these patients should be probably individualized.

Keywords: Breast cancer; Meta-analysis; Microinvasive; Sentinel node biopsy.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Neoplasm Invasiveness
  • Neoplasm Micrometastasis
  • Sentinel Lymph Node Biopsy* / standards