The value of sentinel lymph-node biopsy after neoadjuvant therapy: an overview

• JuanC. Vázquez ^[1] ; Antonio Piñero ^[2] ; Francisco Javier de Castro ^[9] ; Ana Lluch ^[3] ; Miguel Martín ^[4] ; Agustí Barnadas ^[5] ; Emilio Alba ^[10] ; Álvaro Rodríguez-Lescure ^[6] ; Federico Rojo ^[7] ; Julia Giménez ^[11] ; Iván Solá ^[12] ; María Jesús Quintana ^[12] ; Xavier Bonfill ^[8] ; Gerard Urrutia ^[8] ; Pedro Sánchez-Rovira ^[13]
  1. [1] Instituto de Investigación Sanitaria Fundación para la Investigación del Hospital Clínico de Valencia

     Instituto de Investigación Sanitaria Fundación para la Investigación del Hospital Clínico de Valencia

     Valencia, España

     
  2. [2] Hospital Virgen de la Arrixaca

     Hospital Virgen de la Arrixaca

     Murcia, España

     
  3. [3] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  4. [4] Universidad Complutense de Madrid

     Universidad Complutense de Madrid

     Madrid, España

     
  5. [5] Hospital de la Santa Creu i Sant Pau

     Hospital de la Santa Creu i Sant Pau

     Barcelona, España

     
  6. [6] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  7. [7] Fundación Jiménez Díaz

     Fundación Jiménez Díaz

     Madrid, España

     
  8. [8] Universitat Autònoma de Barcelona

     Universitat Autònoma de Barcelona

     Barcelona, España

     
  9. [9] Hospital Nuestra Señora de Sonsoles de Ávila, GEICAM Spanish Breast Cancer Group, Ávila
  10. [10] UGCI Oncología Médica, Hospitales Regional y Virgen de la Victoria, IBIMA. Málaga
  11. [11] Instituto Valenciano de Oncologia-IVO- GEICAM Spanish Breast Cancer Group, Valencia
  12. [12] Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona
  13. [13] Medical Oncology Unit, Complejo Hospitalario de Jaén, GEICAM Spanish Breast Cancer Group, Jaén

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 9, 2022, págs. 1744-1754
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose We conducted a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) after the neoadjuvant chemotherapy, compared to axillary lymph-node dissection, in terms of false-negative rate (FNR) and sentinel lymph-node identification rate (SLNIR), sensitivity, negative predictive value (NPV), need for axillary lymph-node dissection (ALND), morbidity, preferences, and costs.

    Methods MEDLINE, Embase, Scopus, and The Cochrane Library were searched. We assessed the quality of the included systematic reviews using AMSTAR2 tool, and estimated the degree of overlapping of the individual studies on the included reviews.

    Results Six systematic reviews with variable quality were selected. We observed a very high overlapping degree across the included reviews. The FNR and the SLNIR were quite consistent (FNR 13–14%; SLNIR ~ 90% or higher). In women with initially clinically node-negative breast cancer, the FNR was better (6%), with similar SLNIR (96%). The included reviews did not consider the other prespecified outcomes.

    Conclusions It would be reasonable to suggest performing an SLNB in patients treated with NACT, adjusting the procedure to the previous marking of the affected lymph node, using double tracer, and biopsy of at least three sentinel lymph nodes. More well-designed research is needed.