AB121. SOH25_AB_270. Oncological outcomes of sentinel lymph node biopsy alone in those with residual nodal disease after neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis
Systematic Reviews Session

AB121. SOH25_AB_270. Oncological outcomes of sentinel lymph node biopsy alone in those with residual nodal disease after neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis

Jennifer McGarry, Alexandra Zaborowski, Fabian Wehrmann, Denis Evoy, Claire Rutherford, Jane Rothwell, Damian McCartan, Ruth Prichard, Michael Boland

Department of Breast Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: Axillary lymph node dissection (ALND) remains the standard of care for breast cancer patients with a positive sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT). There is a paucity of evidence regarding omission of ALND in this setting given that nodal positivity is thought to indicate more aggressive tumour biology and chemoresistance. The aim of this review was to compare long term oncological outcomes with/without ALND in patients with a positive SLNB after NACT.

Methods: A systematic review was performed following PRISMA guidelines. The primary outcome was overall survival (OS). Secondary outcomes included axillary recurrence (AR) and distant recurrence (DR). AR, and DR at 5 years were expressed as dichotomous variables and pooled as odds ratios (ORs) using the Mantel-Haenszel method.

Results: A total of nine studies, including 10,535 patients, were included. Median follow-up was 45.25 months (range, 2.5–182.7 months). Omission of ALND was not associated with any difference in OS [OR =0.90; 95% confidence interval (CI): 0.64–1.26; P=0.54] or rate of AR at 5 years (OR =1.08; 95% CI: 0.64–1.83; P=0.77) between the two groups. Rates of DR were significantly lower in patients where ALND was omitted (OR =0.66; 95% CI: 0.48–0.91; P=0.01).

Conclusions: Omission of ALND is not associated with inferior long term oncological outcomes in patients with a positive sentinel node biopsy after NACT. Although further prospective evidence is required, it is likely that select patients with limited nodal positivity after NACT could avoid ALND and its associated morbidity.

Keywords: Axillary lymph node dissection (ALND); breast cancer; neoadjuvant chemotherapy (NACT); overall survival (OS); sentinel lymph node biopsy (SLNB)

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab121
Cite this abstract as: McGarry J, Zaborowski A, Wehrmann F, Evoy D, Rutherford C, Rothwell J, McCartan D, Prichard R, Boland M. AB121. SOH25_AB_270. Oncological outcomes of sentinel lymph node biopsy alone in those with residual nodal disease after neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis. Mesentery Peritoneum 2025;9:AB121.

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