Systematic Review Of Axillary Excision Versus No Axillary Excision For Early Staging Elderly Patients With Breast Cancer

Objective:To review the efficacy that no axillary lymph node excision surgery compared with axillary lymph node excision surgery for ealry staging elderly patients with breast cancer.Methods:The electronic bibliographic databases, including PubMed,Embase, Cochrane Central Register of Controlled Trials, CBM, CNKI and VIP were searched to assemble the randomized controlled trials (RCTs), and reference lists of relevant to axillary lymph node excision for elder women with breast cancer and reviewed for additional trials. Their data were extracted and evaluated by two reviewers independently with a designed extraction form. the statistic analysis was conducted by using RevMan 5.0 software. Results:Five studies were enrolled which included three randomized controlled trials (RCT) and two quasi-RCT, and involved totally 1635 patients.No significant differences were found between axillary excision surgery and no axillary excision in terms of survival rate,mortality, local relapse rate and distant metastasis rate at 5 years and 10years.when five years, While axillary excision group was with significantly lower local relapse rate,however (5%vs9%[OR=0.54,95%CI (0.36,0.80); P=0.002],at ten years,this diffents disappear.when 25 years,there is also no difference between two groups.Conclusion: When elderly patients with clinical negative breast cancer at early staged,they are able to tolerate surgery, both axillary excision surgery and no axillary excision, no axillary excision have the same expectation of the life,should be a superior option. Since the comparison study on axillary excision surgery and no axillary excision is limited currently, it is necessary to develop and design more high quality randomized controlled trials...