Sentinel Lymph Node Micrometastasis And Risk Of Breast Cancer Recurrence: A Systematic Review And Meta Analysis

Objective To systemically evaluate the recurrence related event rate(RRER)and regional recurrence(RR)of breast cancer with sentinel lymph node micrometastasis(SLN MIC)without axillary lymph node dissection(ALND).Methods Databases such as PubMed,EMBASE,WanFang Data,CNKI and CBM were searched comprehensively for studies about SLN for breast cancer from foundation to May 1st,2018.On the basis of the inclusion criteria(?.Did not undergo ALND;?.Prospective observational study and retrospective cohort study;?.Single and primary invasive tumor in unilateral breast;?.The diameter of tumor is less then or equal to 5cm;?.Surgical treatment was acceptable and pathology confirmed the SLN metastasis status postoperative;?.There was a clear experimental group and a control group;?.When both studies were reported by the same research center,the research with high literature quality or the recently published research were selected)and exclusion criteria(?.The same research was published in different time or journal;?.The data of outcome indicators cannot be extracted from the paper or inconsistent with this study;?.Abstract,theoretical essays,case reports and reviews were exclude;?.Full text were not obtain),extracting data,assessing methodological quality and analyzing results was achieved.RevMan 5.2 was used to carry out statistical analyses and Stata SE was applied to test publication bias.Results A total of six studies,including 3 prospective observational studies and 3retrospective studies involving 1 730 patients of whom 370 had SLN MIC and 1 360had negative SLN(-),were qualified for final analysis.The odds ratio(OR)of RRER between group SLN MIC and group SLN(-)of breast cancer patients who didn't performed ALND was 1.37(95%CI:0.72-2.59,I~2=47%,P=0.34),without statistical differences.In addition,there was also no statistical difference in regional recurrence between group SLN MIC and group SLN(-)of breast cancer patients without ALND(OR=1.49,95%CI:0.75~2.97,I~2=40%,P=0.26).Conclusion Compared with patients with negative SLN,SLN MIC does not increase the risk of recurrence in breast cancer patients without ALND.