Axillary lymph node dissection vs sentinel biopsy only among women with early-stage breast cancer and sentinel node metastasis: A systematic review and meta-analysis

Axillary lymph node dissection (ALND) in early-stage breast cancer with limited sentinel node metastasis may not be superior to sentinel lymph node dissection (SLND). We performed a meta-analysis comparing SLND/Radiotherapy (RT) with ALND. All data were analyzed using Review Manager Software 5.3. Five randomized controlled trials (RCTs) were included. Overall survival, death, and disease-free survival were estimated higher in the SLND group compared to the ALND group. Statistically significant differences in axillary recurrence were observed in favor of ALND. Omission of ALND in patients with <3 positive SLNs is indicated.

Automated summary

In early-stage breast cancer with limited sentinel node metastasis, axillary lymph node dissection may not be superior to sentinel lymph node dissection. A meta-analysis comparing the two methods showed higher overall survival and disease-free survival rates in the SLND group, but statistically significant differences in axillary recurrence were observed in favor of ALND, suggesting that ALND may be omitted in patients with fewer than 3 positive sentinel lymph nodes.