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The value of sentinel lymph-node biopsy in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy: a systematic review

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Abstract

Purpose

To conduct a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy, compared to axillary lymph-node dissection.

Methods

The more relevant databases were searched. Main outcomes were false-negative rate (FNR), sentinel lymph-node identification rate (SLNIR), negative predictive value (NPV), and accuracy. We conducted meta-analyses when appropriate.

Results

Twenty studies were included. The pooled FNR was 0.14 (95% CI 0.11–0.17), the pooled SLNIR was 0.89 (95% CI 0.86–0.92), NPV was 0.83 (95% CI 0.79–0.87), and summary accuracy was 0.92 (95% CI 0.90–0.94). SLNB performed better when more than one node was removed and double mapping was used.

Conclusions

SLNB can be performed in women with a node-negative tumour after neoadjuvant therapy. It has a better performance when used with previous marking of the affected node and with double tracer.

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Funding

The authors received funding from GEICAM Spanish Breast Cancer Group. This work was developed within a project aimed to update the GEICAM previous clinical guidelines.

Author information

Authors and Affiliations

  1. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain

    Juan C. Vázquez

  2. GEICAM Spanish Breast Cancer Group, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain

    Antonio Piñero

  3. Complejo Asistencial de Salamanca, GEICAM Spanish Breast Cancer Group, Salamanca, Spain

    Francisco J. de Castro

  4. Medical Oncology Unit, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Biomedical Research Institute INCLIVA, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, Spain

    Ana Lluch

  5. Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Universidad Complutense de Madrid, Madrid, Spain

    Miguel Martín

  6. Medical Oncology Unit, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain

    Agustí Barnadas

  7. Centro de Investigación Biomédica en Red de Oncología, GEICAM Spanish Breast Cancer Group, UGCI Oncología Médica, Hospitales Regional y Virgen de la Victoria, IBIMA, CIBERONC-ISCIII, Málaga, Spain

    Emilio Alba

  8. GEICAM Spanish Breast Cancer Group, Hospital General Universitario de Elche, Alicante, Spain

    Álvaro Rodríguez-Lescure

  9. Centro de Investigación Biomédica en Red de Oncología, GEICAM Spanish Breast Cancer Group, Hospital Universitario Fundacion Jimenez Diaz, CIBERONC-ISCIII, Madrid, Spain

    Federico Rojo

  10. Instituto Valenciano de Oncologia-IVO-GEICAM Spanish Breast Cancer Group, Valencia, Spain

    Julia Giménez

  11. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Ivan Solá

  12. Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Autònoma de Barcelona, Barcelona, Spain

    Maria J. Quintana, Xavier Bonfill & Gerard Urrutia

  13. Medical Oncology Unit, GEICAM Spanish Breast Cancer Group, Complejo Hospitalario de Jaén, Jaén, Spain

    Pedro Sánchez-Rovira

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  1. Juan C. Vázquez
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Juan Carlos Vazquez is PhD candidate Program in Biomedical Research Methodology and Public Health, Universitat Autònoma de Barcelona.

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Vázquez, J.C., Piñero, A., de Castro, F.J. et al. The value of sentinel lymph-node biopsy in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy: a systematic review. Clin Transl Oncol 25, 417–428 (2023). https://doi.org/10.1007/s12094-022-02953-1

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  • DOI: https://doi.org/10.1007/s12094-022-02953-1

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