Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

Zada, A, Peek, M, Muneer, A, Bauke, A, Baker, RD, Kusakabe, M, Sekino, M, Klaase, JM, ten Haken, B and Douek, M 2016, 'Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique' , British Journal of Surgery, 103 (11) , pp. 1409-1419.

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Abstract

Background 3 The gold standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and 4 blue dye), has several drawbacks. A novel magnetic technique without these drawbacks, has been 5 evaluated in a number of clinical trials. It utilizes a magnetic tracer and a hand-held magnetometer to 6 identify and excise sentinel lymph nodes (SLNs). A systematic review and meta-analysis was performed 7 to assess the performance and utility of magnetic in comparison to the standard technique. 8 Method 9 Medline, PubMed, Embase and the Cochrane online literature databases were used to identify all 10 original articles published up to April 2016, evaluating the magnetic technique for SLNB. Studies were 11 included if they were prospectively conducted clinical trials comparing magnetic to standard technique 12 for SLNB in patients with breast cancer. 13 Results 14 Seven studies were included and magnetic technique was non-inferior to standard technique (z=3.87, 15 p<0.001), at a 2% non-inferiority margin. The mean identification rates for standard and magnetic 16 technique were 96.8% (94.2-99.0%) and 97.1% (94.4-98.0%) respectively (p=0.690, RD 0.0, 95% CI [- 17 0.01-0.01]). The total lymph node retrieval (LNR) was significantly higher with magnetic compared to 18 standard technique (2,113 (1.9 per patient) versus 2,000 (1.8 per patient); p=0.003, RD 0.05, 95% CI 19 [0.03-0.06]). False-negative rates were 10.9% (5.6-22.3%) for standard technique and 8.4% (1.6-22.3%) 20 for magnetic technique (p=0.551, RD 0.03; 95% CI [0.00-0.06]). The mean discordance rate was 3.9% 21 (1.7-6.9%). 22 Conclusion 23 The magnetic technique for SLNB is non-inferior to standard technique, with a high identification rate 24 but with a significantly higher lymph node retrieval rate.

Item Type: Article
Schools: Schools > Salford Business School
Journal or Publication Title: British Journal of Surgery
Publisher: Wiley Blackwell
ISSN: 0007-1323
Depositing User: Prof Rose Dawn Baker
Date Deposited: 31 Jan 2017 15:57
Last Modified: 31 Jan 2017 15:57
URI: http://usir.salford.ac.uk/id/eprint/41274

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