The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: Systematic review and meta-analysis of the literature

Abstract 

Background

One of the subjects under debate in sentinel node mapping is the eligibility of patients with the history of previous surgical biopsy of the primary lesion for sentinel node biopsy. In the current systematic review, we evaluated the false negative and detection rates of sentinel node biopsy in breast cancer patients with and without previous surgical manipulation of the primary breast lesions.

Methods

Pubmed, SCOPUS, and Google scholar were searched for any relevant study with head to head comparison of patients with and without history of previous surgical manipulation of the primary breast lesions. The outcomes of interest were detection and false negative rates in each group, and odds ratio as well as risk difference of having sentinel node detection failure or getting false negative results in the surgical biopsy compared to the non-surgical biopsy group.

Results

18 studies for false negative rate and 68 studies for detection rate evaluation were included in this review. Pooled detection rates for patients with and without previous surgical biopsy were 91.3% and 92.8%. Odds ratio and risk difference of having detection failure during surgery were 1.16 and 0.002 respectively. Pooled false negative rates for patients with and without previous surgical biopsy were 12.3% and 9.9%. Odds ratio and risk difference of having false negative results were 1.4 and 0.02 respectively.

Conclusion

Surgical biopsy of the primary breast malignant lesions does not affect the detection rate of sentinel lymph node biopsy procedure. However, false negative rate seems to be slightly higher. We believe that the advantages of sentinel node biopsy outweigh this small difference.

Keywords: Breast cancer, Systematic review, Excisional biopsy, Sentinel node biopsy, Meta-analysis, Needle biopsy