Can axillary lymph node dissection be omitted in breast cancer patients with 1-2 positive sentinel nodes? A systematic review and meta-analysis
SLNB alone provides comparable survival outcomes to ALND in early breast cancer (EBC) patients with 1-2 positive SLNs, supporting its safety in those undergoing BCS. However, while our analysis suggests a potential survival advantage with ALND in TM patients and those with advanced T-stage (T3-4), this observation requires cautious interpretation due to potential selection bias, residual confounding from unmeasured variables and confounding by indication where ALND may reflect more intensive multimodal therapy rather than causally improving OS. Therefore, these subgroup findings should not be considered practice-changing at this stage. Further high-quality prospective studies are warranted to validate these associations and optimize patient selection criteria.
Authors
- Qifeng Yang (ORCID: https://orcid.org/0000-0003-0576-8513)
- Jie Hao (ORCID: https://orcid.org/0009-0002-7208-7443)
- Pengfei Zhu (ORCID: https://orcid.org/0000-0003-2141-8636)
- Juan Xie (ORCID: https://orcid.org/0000-0001-7664-5532)
- Ning Zhang (ORCID: https://orcid.org/0000-0002-6430-4236)
- Haoyu Wang (ORCID: https://orcid.org/0000-0002-6367-303X)
- Bing Chen (ORCID: https://orcid.org/0000-0003-0168-8532)
- Xiaochen Zhang (ORCID: https://orcid.org/0000-0002-1851-0098)
- Wenjing Zhao (ORCID: https://orcid.org/0000-0002-6282-6356)
- Siyue Zhang (ORCID: https://orcid.org/0000-0003-2723-9428)
- Lijuan Wang (ORCID: https://orcid.org/0000-0002-7728-9282)
- Tong Wan
Institutions
- Shandong University (CN)
- Shandong Tumor Hospital (CN)
- Qilu Hospital of Shandong University (CN)
- Shandong First Medical University (CN)
Publication Details
- Journal
- The Oncologist
- Published
- 2025-11-13
- DOI
- https://doi.org/10.1093/oncolo/oyaf379
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Natural Science Foundation of Shandong Province