SynthesisCancer medicine2022
Diagnostic accuracy of de-escalated surgical procedure in axilla for node-positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta-analysis.
Synthesis in Cancer medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Diagnostic accuracy of de-escalated surgical procedure in axilla for node-positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta-analysis.Cancer medicine · 2022Pooled it
- Accuracy and Utility of Preoperative Ultrasound-Guided Axillary Lymph Node Biopsy for Invasive Breast Cancer: A Systematic Review and Meta-Analysis.Computational intelligence and neuroscience · 2022Pooled it
- Article
- Ultrasonographic accuracy in evaluating response of clipped lymph nodes in targeted axillary dissection in breast cancer.Scientific reports · 2025Article
- Non-Palpable Breast Cancer: A Targeting Challenge-Comparison of Radio-Guided vs. Wire-Guided Localization Techniques.Biomedicines · 2024Article
- Melanin-Based Nanoparticles for Lymph Node Tattooing: Experimental, Histopathological and Ultrastructural Study.Nanomaterials (Basel, Switzerland) · 2024Article
- Clipping a Positive Lymph Node Improves Accuracy of Nodal Staging After Neoadjuvant Chemotherapy for Breast Cancer Patients, but Does It Drive Management Changes?Annals of surgical oncology · 2024Article
- Targeted axillary dissection: worldwide variations in clinical practice.Breast cancer research and treatment · 2024Article
- Review
- Axillary surgery in oncologic breast surgery: a narrative review.Gland surgery · 2023Review
- Applicability of magnetic seeds for target lymph node biopsy after neoadjuvant chemotherapy in initially node-positive breast cancer patients: data from the AXSANA study.Breast cancer research and treatment · 2023Observational
- Ideal marker for targeted axillary dissection (IMTAD): a prospective multicentre trial.World journal of surgical oncology · 2023Article
- Conservative Surgery in cT4 Breast Cancer: Single-Center Experience in the Neoadjuvant Setting.Cancers · 2023Article
- Feasibility and accuracy of targeted axillary dissection in breast cancer patients; single center experience.Frontiers in surgery · 2023Article
- Changes in Oncological Surgical Principles Driven by Advances in Preoperative Treatments.Therapeutics and clinical risk management · 2023Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMore initial clinical node-positive breast cancer patients achieve axillary pathological complete response (ax-pCR) after neoadjuvant systemic therapy (NST). Restaging axillary status and performing de-escalated surgical procedures to replace routine axillary lymph nodes dissection (ALND) is urgently needed. Targeted axillary lymph node biopsy (TLNB) is a novel de-escalated surgical strategy marking metastatic axillary nodes before NST and targeted dissection and biopsy intraoperatively to tailor individual axillary management.
methodsThis study provided a systematic review and meta-analysis to evaluate the feasibility and diagnosis accuracy of TLNB. Prospective and retrospective clinical trials on TLNB were searched from Pubmed, Embase, and Cochrane. Identification rate (IFR), false-negative rate (FNR), negative predictive value (NPV), and rate of ax-pCR were the outcomes of this meta-analysis.
resultsOne thousand nine hundred and twenty patients attempted TLNB, with an overall IFR of 93.5% (95% confidence interval [CI] 90.1%-96.2%). IFR of three nodal marking methods, namely iodine seeds, clips, and carbon dye, was 95.6% (95% CI 91.2%-98.7%), 91.7% (95% CI 87.3%-95.4%), and 97.1% (95% CI 89.1%-100.0%), respectively. Of them, 847 patients received ALND, with an overall FNR of 5.5% (95% CI 3.3%-8.0%), and NPV ranged from 90.1% to 96.1%. Regression analysis showed that the overlap of targeted and sentinel biopsied nodes might associate with IFRs and FNRs.
conclusionTLNB is a novel, less invasive surgical approach to distinguish initial node-positive breast cancer that achieves negative axillary conversion after NST. It yields an excellent IFR with a low FNR and a high NPV. A combination of preoperative imaging, intraoperative TLNB with SLNB, and postoperative nodal radiotherapy might affect the future treatment paradigm of primary breast cancer with nodal metastases.
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