Sentinel Lymph Node Biopsy Versus Axillary Lymph Node Dissection For Patients With Breast Cancer;a Systemic Review

Objective: To evaluate the efficacy and safety of sentinel lymph node biopsy,compared with axillary lymph node dissection for patients with breast cancer. Methods:We searched the CBM-disc(1978-2011.4), CNKI(1978-2011.4), PubMed(1966-2011.4),Cochrane Library(Issue3,2011), Embase(1974-2011.4), included all of the clinicalcontrolled trials comparing SLNB with ALND in the management of patients with breastcancer, extracted the data, assessed the quality and analysed the reslults for the includedstudies. For disease-free survival, overall survival, locoregional relapse rate, distantmetastasis rate and death duo to breast cancer rate, we used relative risks(RR), and95%confidence intervals(CI) for analysis, applying fixed effective model, ReviewManager software5.1.2. For quality of life(QOL), we used qualitative analysis. Results：Nine studies were finally included. All of which were randomized controlled trial(RCT),involving3709patients together. Five of the nine studies were for disease-free survival,overall survival, distant metastasis rate. Six studies were for locoregional relapse rate anddeath duo to breast cancer rate. One studies was for QOL. For disease-free survival,overall survival, locoregional relapse rate, distant metastasis rate at3years,5years,10years, they had no statistical significance. For locoregional relapse rate and death duo tobreast cancer rate at1year,3years,5years, they had no statistical significance. And forQOL, the outment of SLNB was prior to ALND. Conclusions：SLNB should be a superioroption for patients with single, node-negative. The trails available for this SR are limited,which exposes the need for implementation of high quality RCTs regarding patients withbreast cancer treated with SLNB and ALND, to further confirm the conclusion of thissystematic review(SR).