PMID- 27671032
OWN - NLM
STAT- MEDLINE
DCOM- 20170327
LR  - 20170817
IS  - 1879-1883 (Electronic)
IS  - 0002-9610 (Linking)
VI  - 212
IP  - 5
DP  - 2016 Nov
TI  - Is sentinel lymph node biopsy a viable alternative to complete axillary
      dissection following neoadjuvant chemotherapy in women with node-positive breast 
      cancer at diagnosis? An updated meta-analysis involving 3,398 patients.
PG  - 969-981
LID - S0002-9610(16)30433-0 [pii]
LID - 10.1016/j.amjsurg.2016.07.018 [doi]
AB  - BACKGROUND: The use of sentinel lymph node biopsy (SLNB) following neoadjuvant
      chemotherapy (NAC) in patients presenting with clinically positive lymph nodes
      remains controversial. METHODS: A computer-aided search of the literature
      regarding SLNB in clinically node-positive breast cancer treated with NAC was
      carried out to identify the false negative rate (FNR), sentinel lymph node
      identification rate (IR), and axillary pathological complete response (pCR).
      RESULTS: Nineteen articles were used in the analysis yielding 3,398 patients. The
      pooled estimate of the FNR was 13% and that of the IR was 91%. The adjusted pCR
      rate was 47%. A trend toward significance was observed with only clinical stage
      N1 (cN1) disease whereby clinical stage N1 was associated with an increased pCR
      rate when compared to N2 or N3 disease (P = .06). CONCLUSIONS: SLNB after NAC in 
      biopsy-proven node-positive patients results in reasonably acceptable FNR and IR,
      making it a valid alternative management strategy to axillary dissection. More
      refined patient selection and optimal techniques can improve the FNR and IR in
      this patient population.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - El Hage Chehade, Hiba
AU  - El Hage Chehade H
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK.
FAU - Headon, Hannah
AU  - Headon H
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK.
FAU - El Tokhy, Omar
AU  - El Tokhy O
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK.
FAU - Heeney, Jennifer
AU  - Heeney J
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK.
FAU - Kasem, Abdul
AU  - Kasem A
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK.
FAU - Mokbel, Kefah
AU  - Mokbel K
AD  - The London Breast Institute, The Princess Grace Hospital, 42-52 Nottingham Place,
      London W1U 5NY, UK. Electronic address: kefahmokbel@hotmail.com.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20160816
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Axilla
MH  - Breast Neoplasms/mortality/*pathology/*therapy
MH  - False Negative Reactions
MH  - Female
MH  - Humans
MH  - Lymph Node Excision/methods
MH  - Lymph Nodes/pathology/surgery
MH  - Mastectomy/methods
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Neoplasm Invasiveness/pathology
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Risk Assessment
MH  - Sentinel Lymph Node/pathology
MH  - Sentinel Lymph Node Biopsy/*methods/statistics & numerical data
MH  - Survival Analysis
OTO - NOTNLM
OT  - *Breast cancer
OT  - *Neoadjuvant chemotherapy
OT  - *Node positive
OT  - *Sentinel lymph node biopsy
EDAT- 2016/10/25 06:00
MHDA- 2017/03/28 06:00
CRDT- 2016/09/28 06:00
PHST- 2016/05/12 00:00 [received]
PHST- 2016/07/21 00:00 [revised]
PHST- 2016/07/23 00:00 [accepted]
PHST- 2016/10/25 06:00 [pubmed]
PHST- 2017/03/28 06:00 [medline]
PHST- 2016/09/28 06:00 [entrez]
AID - S0002-9610(16)30433-0 [pii]
AID - 10.1016/j.amjsurg.2016.07.018 [doi]
PST - ppublish
SO  - Am J Surg. 2016 Nov;212(5):969-981. doi: 10.1016/j.amjsurg.2016.07.018. Epub 2016
      Aug 16.