SynthesisAnnals of surgical oncology2021
Axillary Management in Women with Early Breast Cancer and Limited Sentinel Node Metastasis: A Systematic Review and Metaanalysis of Real-World Evidence in the Post-ACOSOG Z0011 Era.
Synthesis in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Can axillary lymph node dissection be omitted in breast cancer patients with 1-2 positive sentinel nodes? A systematic review and meta-analysis.The oncologist · 2025Pooled it
- Pooled it
- Axillary management in patients with clinical node-negative early breast cancer and positive sentinel lymph node: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Efficacy of different sentinel lymph node biopsy protocols in oral squamous cell carcinoma: Systematic review and meta-analysis.Head & neck · 2022Pooled it
- Omission of intraoperative frozen section in sentinel lymph node biopsy for early breast cancer: impact on survival outcomes.Gland surgery · 2026Article
- Spectral Precision: The Added Value of Dual-Energy CT for Axillary Lymph Node Characterization in Breast Cancer.Cancers · 2026Article
- Article
- Diagnostic value of different contrast-enhanced ultrasound (CEUS) methods for sentinel lymph node metastasis in patients with breast neoplasms: a meta-analysis and indirect comparison.Quantitative imaging in medicine and surgery · 2025Article
- Article
- Sentinel Lymph Node Biopsy Predicts Non-Sentinel Lymph Node Metastases and Supports Omission of Axillary Lymph Node Dissection in Breast Cancer Patients.Journal of clinical medicine · 2025Article
- Clinical impact of the Z0011 trial on axillary surgical management in Australia and New Zealand from the BreastSurgANZ Quality Audit.ANZ journal of surgery · 2025Article
- Accuracy and Outcomes of Sentinel Lymph Node Biopsy in Male with Breast Cancer: A Narrative Review and Expert Opinion.Current oncology (Toronto, Ont.) · 2024Review
- Exploring Label-Free Imaging Techniques with Copper Sulfide Microspheres for Observing Breast Cancer Cells.ACS omega · 2024Article
- Current axillary management of patients with early breast cancer and low-volume nodal disease undergoing primary surgery: results of a United Kingdom national practice survey.Breast cancer research and treatment · 2024Article
- An exploratory study of whether axillary lymph node dissection can be avoided in breast cancer patients with positive lymph nodes.Translational cancer research · 2024Article
- Axillary Surgical Attitude Changing with Retrospective Application ofEuropean journal of breast health · 2023Article
- A novel nomogram and risk classification system for predicting lymph node metastasis of breast mucinous carcinoma: A SEER-based study.Cancer medicine · 2022Article
- Is Routine Intraoperative Frozen Section Analysis of Sentinel Lymph Nodes Necessary in Every Early-Stage Breast Cancer?Breast cancer (Dove Medical Press) · 2022Article
- Sentinel node involvement with or without completion axillary lymph node dissection: treatment and pathologic results of randomized SERC trial.NPJ breast cancer · 2021Article
- Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis.Scientific reports · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter the publication of the Z0011 trial, the American Society of Clinical Oncology published an updated clinical practice guideline stating that clinicians should not recommend axillary lymph node dissection (ALND) for early-stage breast cancer patients with the involvement of one or two sentinel lymph nodes (SLNs). However, these recommendations have been challenged because they were mainly based on data from limited studies. The aim of the current study is to systematically compare the real-world outcomes of SLN biopsy (SLNB) alone and SLNB + ALND in patients with early-stage breast cancers and limited positive SLN metastasis in the post-Z0011 era PATIENTS AND
methodsWe searched articles in the PubMed, EMBASE, and Cochrane library databases. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoints were recurrence rate and the incidence of lymphedema.
resultsOne randomized controlled trial and six retrospective studies with 8864 patients were retrieved. For patients with early-stage breast cancer with one or two SLN metastases, receiving SLNB alone showed no significant difference in OS, DFS, and recurrence rate compared with receiving SLNB + ALND. The incidence of lymphedema in patients who received SLNB alone was significantly lower than those who received SLNB + ALND (odds ratio 1.95, 95% confidence interval 1.02-3.71).
conclusionsCurrent real-world evidence proved that the Z0011 strategy is safe with respect to survival outcomes and effective in reducing the incidence of lymphedema. ALND should be avoided in patients with early-stage breast cancer with one or two SLN metastases in the post-Z0011 era.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.