Table 1 The characteristics of the included 20 studies reported by 24 papers
Author publication year | Study design | Lymph bode category | Sample size (n), total (SLNB group/ALND group) | Positive SLN, n (SLNB group/ALND group) | Age (years), total (SLNB group/ALND group) | Tumor size, total (SLNB group/ALND group) | Axillary intervention | Median follow-up, months or specified | Primary outcome(s) |
|---|---|---|---|---|---|---|---|---|---|
Lucci et al. (2007) ACOSOG Z0011 [30] | RCT | Not specified | 821(417/404) | Range: (1–2/1–2) | Median: not specified for total (54/56) | T2: 252 (120/132) | SLNB alone versus SLNB + complete ALND | Not specified | Adverse surgical effects |
Bilimoria et al. (2009) [31] | Retrospective cohort study | Micro | 10,259 (3,674/6,585) | Not specified | Median: 56 (58/56) | Median: 2.0 (1.8/2.1) cm | SLNB alone versus SLNB + complete ALND | 63 | Axillary recurrence and survival |
Macro | 87,055 (16,543/70,512) | ||||||||
Degnim et al. (2010) [32] | Retrospective cohort study | ITC | 81 (50/31) | Range: (1–3/1–3) | Mean, not specified for total (50/58) | Number of T2 + T3: 29 (15/14) | SLNB alone versus SLNB + complete ALND | 38 | Predicted probability of non-sentinel node metastasis and breast recurrence |
Giuliano et al. (2010) ACOSOG Z0011 [33] | RCT | Micro | 280 (160/120) | Range: (1–2/1–2) | Median: not specified for total (54/56) | Number of T2: 251 (124/127) | SLNB alone versus SLNB + complete ALND | 6.3 years | Locoregional recurrence |
Macro | 418 (219/199) | ||||||||
Unknown | 115 (66/49) | ||||||||
Yi et al. (2010) [34] | Retrospective cohort study | Micro | 6,838 (2,240/4,598) | Range: (1–24/1–54) | Median: not specified for total (59/56) | Number of T2 + T3: 12,166 (1,430/10,736) | SLNB alone versus SLNB + complete ALND | 50 | OS and breast cancer-specific mortality |
Macro | 20,148 (2,185/17,963) | ||||||||
Giuliano et al. (2011) ACOSOG Z0011 [12] | RCT | Not specified | 856 (436/420) | Range: (1–2/1–2) | Median: not specified for total (54/56) | Number of T2: 260 (126/134) | SLNB alone versus SLNB + complete ALND | 6.3 years | OS |
Gillanders et al. (2012) [35] | Retrospective cohort study | Micro | 78 (31/47) | Not specified | Median: not specified for total (57/51) | Number of T2 + T3: 102 (19/83) | SLNB alone versus SLNB + complete ALND | 73 for SLNB group/ 69 for ALND group | Recurrence and breast cancer-specific mortality |
Macro | 198 (39/159) | ||||||||
Galimberti et al. (2013) IBCSG 23–01 [13] | RCT | Micro | 931 (467/464) | Range: (1–2/1–2) | Median: not specified for total (54/53) | Number of > 2 cm: 281 (140/141) | SLNB alone versus SLNB + complete ALND | 5 years | DFS |
Sola et al. (2013) AATRM 048/13/2000 [36] | RCT | Micro | 233 (121/112) | Not specified | Mean, not specified for total (53.2/ 55.3) | Mean, not specified for total (1.78/1.57) cm | SLNB alone versus SLNB + complete ALND | 62 | DFS |
Park et al. (2014) [37] | Retrospective cohort study | Not specified | 2545 (197/ 2,348) | 94.9% ≤ 3/ 74.4% ≤ 3 | Mean, not specified for total (47.9/ 48.7) | Number of T2: 101 (67/34) | SLNB alone versus SLNB + complete ALND | 42 | OS |
Snow et al. (2015) [38] | Retrospective cohort study | Not specified | 318 (60/258) | Range: (1–2/1–10) | Median: 54 (58, 53) | Mean, not specified for total (1.86/ 2.35) cm | SLNB alone versus SLNB + complete ALND | 45.5 | OS and recurrence |
Tvedskov et al. (2015) [39] | Retrospective cohort study | Micro | 1,673 (136/ 1,537) | Not specified | Mean: 77 (71/ 78) | Number of > 2 cm: 562 (55/507) | SLNB alone versus SLNB + complete ALND | Not specified | Axillary recurrence and OS |
ITC | 401 (104/ 297) | Number of > 2 cm: 175 (48/127) | |||||||
Houvenaeghel et al. (2016) [40] | Retrospective cohort study | Micro | 1390 (191/1199) | More than 99% ≤ 2 | Median: 56 (not specified) | Number of > 2 cm: 264 (39/225) | SLNB alone versus SLNB + complete ALND | 60.4 | OS and recurrence-free survival |
ITC | 619 (147/472) | Number of > 2 cm: 127 (23/104) | |||||||
Youssef et al. (2016) [41] | Retrospective cohort study | Micro or ITC | 95 (57/38) | Range: (1–2/1–2) | Not specified for median or mean | Number of > 2 cm: 41 (23/18) | SLNB alone versus SLNB + complete ALND | 34.2 | Locoregional recurrence and lymphedema rate |
Giuliano et al. (2017) ACOSOG Z0011 (Alliance) [42] | RCT | Not specified | 856 (436/420) | Not specified | Median: not specified for total (54/56) | Number of T2: 260 (126/134) | SLNB alone versus SLNB + complete ALND | 9.3 years | 10-year OS |
Galimberti et al. (2018) IBCSG 23–01 [43] | RCT | Micro | 931 (467/464) | Range: (1–2/1–2) | Median: not specified for total (54/53) | Number of > 2 cm: 85 (36/49) | SLNB alone versus SLNB + complete ALND | 9.7 years | DFS |
Lee et al. (2018) [44] | Retrospective cohort study | Not specified | 4,442 (1,268/3,174) | Range: (1–2/1–2) | Mean: 49.34 (49.55, 49.26) | Mean: 1.86 (1.81/1.88) | SLNB alone versus SLNB + complete ALND | 47.24 | Disease-specific survival and OS |
Liu et al. (2018) [45] | Retrospective cohort study | Micro | 5,660 (3,689/1,971) | Range: (1/1) | Not specified for median or mean | 1709 (1072/637) | SLNB alone versus SLNB + complete ALND | Not specified | Breast cancer-specific survival |
Arisio et al. (2019) [46] | Retrospective cohort study | Macro | 127 (95/32) | Not specified | Median: Median: not specified for total (57/54) | Number of T2 + T3: 278 (83/195) | SLNB alone versus SLNB + complete ALND | 84.4 | OS and relapse-free survival |
Micro | 199 (115/84) | ||||||||
Jung et al. (2019) [47] | Retrospective cohort study | Not specified | 1,697 (707/990) | Range: (1–2/1–2) | Median: 49 (50/50) | Mean: 2.1 (2.0/2.2) | SLNB alone versus SLNB + complete ALND | 50 | Disease recurrence |
Kim et al. (2019) [48] | Retrospective cohort study | Not specified | 1,697 (1,539/158) | Range: (1–3/1–3) | Mean: 47.70 (47.59/48.77) | Mean: 2.8 (2.9/2.4) | SLNB alone versus SLNB + complete ALND | 93 | DFS and OS |
Jung et al. (2020) [49] | Retrospective cohort study | Not specified | 23,138 (16,518/6,620) | Range: (1–2/1–2) | Median: 60 (62/59) | Number of T2: 9,464 (6,429/3,035) | SLNB alone versus SLNB + complete ALND | 41 | Breast cancer-specific mortality |
Kim et al. (2020) [50] | Retrospective cohort study | Not specified | 883 (179/704) | Range: (1–2/1–2) | Mean: 50.80 (50.78/50.81) | Number of T2: 474 (96/378) | SLNB alone versus SLNB + complete ALND | 54 | OS |
Sun et al. (2021) [51] | Retrospective cohort study | Not specified | 329 (128/201) | Range: (1–2/1–2) | Median: 53 (56/51) | Median: 2.3 (2.1/2.5) cm | SLNB alone versus SLNB + complete ALND | 51 | locoregional and distant recurrence and OS |
Sanvido et al. (2021) [52] | Retrospective cohort study | Mixed with Macro, ITC and Micro | 97 (56/41) | Range (1–2/1–24) | Mean: 57.8 (58.3/56.3) | Mean: 1.7 (1.8/2/2) cm | SLNB alone versus SLNB + complete ALND | 4.3 years | OS and the locoregional recurrence |
Bartels et al. (2022) EORTC 10981–22023 AMAROS Trial [53] | RCT | Mixed with Macro, ITC and Micro | 1425 (681/744) | Median (2/2) | Median: not specified (55/56) | Median: not specified (18/17) mm | SLNB + ART versus SLNB + complete ALND | 10.0 years | Axillary recurrence rate |
Gao et al. (2022) [54] | Retrospective cohort study | Mixed with Macro, ITC and Micro | 1050 (245/805) | Range: (1–2/1–2) | Median: 51 (not specified) | Number of T2: 501 (92/409) | SLNB alone versus SLNB + complete ALND | 36 | Locoregional recurrence |
Houvenaeghel et al. (2022) [55] | Retrospective cohort study | Micro | 1421 (185/1266) | 99.5% of the patients were ≤ 2 | Median: not specified (58.5/55.5) | > 20 mm: 260 (28/232) | SLNB alone versus SLNB + complete ALND | 54 | OS and DFS |
Tinterri et al. (2022) SINODAR-ONE trial [56] | RCT | Macro | 879 (440/439) | Range: (1–2/1–2) | Mean 56.2 (56.2/56.1) | Not specified | SLNB alone versus SLNB + complete ALND | 34 | OS |
Zhou et al. (2022) [57] | Retrospective cohort study | Micro | 13848 (1965/ 1883) | Not specified | Mean: 57.95 (58.14/56.77) | Mean 23.64 (22.46/ 31.17) mm | SLNB alone versus SLNB + complete ALND | 48 | OS |