Review article (Meta-analysis)Incidence and Time Path of Lymphedema in Sentinel Node Negative Breast Cancer Patients: A Systematic Review
Section snippets
Methods
The literature was systematically reviewed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, addressing the following research questions mentioned above. Four electronic databases were screened online to identify eligible studies: PubMed (October 14, 2013), Web of Science (October 22, 2013), Embase (October 23, 2013), and Cochrane Clinical Trials (October 29, 2013). In order to retrieve eligible studies, Medical Subject Headings and keywords were
Results
Initially the search yielded 635 citations. After the first screening and removal of duplicates, 96 full-text articles were retrieved. After the final screening based on the full texts, 28 studies6, 8, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 were found eligible and included in this review. The results of this systematic review are based on 21 cohort studies,8, 14, 15, 16, 17, 18, 19, 20, 22, 23, 24, 25, 26, 27, 28, 29, 30, 32, 33, 34
Discussion
The results of our systematic review clearly demonstrate that lymphedema is a nonnegligible complication in patients with SLNB-negative breast cancer. The overall range of the lymphedema incidence (0%–63.4%) is very broad. Two studies11, 15 are mainly responsible for this broad range. Both studies have clear limitations, and their results should be appraised critically with regard to the incidences found. Armer et al11 reported on a very low number (n=9) of SLNB patients, of whom 2 (22%)
Conclusions
In patients who have had SLNB, lymphedema is still a problem, usually occurring 6 to 12 months after surgery. Because different assessments and criteria have been used for lymphedema, there is a wide range of reported incidence rates. Clear definitions of lymphedema are absolutely necessary to tailor therapy.
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Supported by the Flemish Government academic fund (grant no. G817-g091).
Disclosures: none.