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The effectiveness of ultrasound-guided core needle biopsy in detecting lymph node metastases in the axilla in patients with breast cancer: systematic review and meta-analysis
Xu, Qi; Wang, Jiale; Wang, Jing; Guo, Runzhao; Qian, Yao; Liu, Feng.
  • Xu, Qi; Harbin Medical University Cancer Hospital. Department of Breast Surgery. Harbin. CN
  • Wang, Jiale; Harbin Medical University Cancer Hospital. Department of Medical Oncology. Harbin. CN
  • Wang, Jing; Harbin Medical University Cancer Hospital. Department of Breast Surgery. Harbin. CN
  • Guo, Runzhao; Harbin Medical University Cancer Hospital. Department of Breast Surgery. Harbin. CN
  • Qian, Yao; Harbin Medical University Cancer Hospital. Department of Breast Surgery. Harbin. CN
  • Liu, Feng; Harbin Medical University Cancer Hospital. Department of Breast Surgery. Harbin. CN
Clinics ; 78: 100207, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1439914
ABSTRACT
Abstract

Objective:

This study aimed to perform a meta-analysis to investigate the diagnostic safety and accuracy of Ultrasound-Guided Core Needle Biopsy (US-CNB) Axillary Lymph Nodes (ALNs) region in patients with Breast Cancer (BC).

Methods:

The authors searched the electronic databases PubMed, Scopus, Embase, and Web of Science for clinical trials about US-CNB for the detection of ALNs in breast cancer patients. The authors extracted and pooled raw data from the included studies and performed statistical analyses using Meta-DiSc 1.4 and Review Manager 5.3 software. A random effects model was used to calculate the data. At the same time, data from the Ultrasound-guided Fine-Needle Aspiration (US-FNA) were introduced for comparison with the US-CNB. In addition, the subgroup was performed to explore the causes of heterogeneity. (PROSPERO ID CRD42022369491).

Results:

In total, 18 articles with 2521 patients were assessed as meeting the study criteria. The overall sensitivity was 0.90 (95% CI [Confidence Interval], 0.87‒0.91; p = 0.00), the overall specificity was 0.99 (95% CI 0.98‒ 1.00; p = 0.62), the overall area under the curve (AUC) was 0.98. Next, in the comparison of US-CNB and US-FNA, US-CNB is better than US-FNA in the diagnosis of ALNs metastases. The sensitivity was 0.88 (95% CI 0.84‒ 0.91; p = 0.12) vs. 0.73 (95% CI 0.69‒0.76; p = 0.91), the specificity was 1.00 (95% CI 0.99‒1.00; p = 1.00) vs. 0.99 (95% CI 0.67‒0.74; p = 0.92), and the AUC was 0.99 vs. 0.98. Subgroup analysis showed that heterogeneity may be related to preoperative Neoadjuvant Chemotherapy (NAC) treatment, region, size of tumor diameter, and the number of punctures.

Conclusion:

US-CNB has a satisfactory diagnostic performance with good specificity and sensitivity in the preoperative diagnosis of ALNs in BC patients.


Full text: Available Index: LILACS (Americas) Type of study: Prognostic study / Systematic reviews Language: English Journal: Clinics Journal subject: Medicine Year: 2023 Type: Article Affiliation country: China Institution/Affiliation country: Harbin Medical University Cancer Hospital/CN

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Full text: Available Index: LILACS (Americas) Type of study: Prognostic study / Systematic reviews Language: English Journal: Clinics Journal subject: Medicine Year: 2023 Type: Article Affiliation country: China Institution/Affiliation country: Harbin Medical University Cancer Hospital/CN