Abstract
We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. The Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database were searched and all randomized controlled trials of axillary dissection in old women (at least 60 years old) were considered. Meta-analyses were completed using RevMan5.1. Three eligible randomized controlled trials (RCTs) including 5,337 patients were considered. There was weak evidence in favour of axillary dissection (AD) in old women. The meta-analysis showed that the overall survival (OS) after 1, 3, 5 and 7 years and the disease free survival (DFS) after 1, 3 and 5 year were not statistically significantly different between AD and no AD groups. However, there was a difference in the 7 year DFS. Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Therefore, axillary dissection is not well-indicated in old women with breast cancer.
Highlights
For many years, axillary dissection was part of the standard treatment of breast cancer following the pioneering studies by Halsted, early in the 20th century (Halsted, 1907)
There were no differences in overall survival or distant metastases in NSABP-04 when old woman with breast cancer were randomized to axillary dissection, axillary radiotherapy, or no axillary treatment (Fisher et al, 2002)
Several clinical studies demonstrated that the incidence of axillary recurrence was very high, when clinically negative axillary nodes in old woman were observed without axillary dissection or radiotherapy (Lythgoe, 1982; Fisher et al, 1985; Ribeiro et al, 1993)
Summary
Axillary dissection was part of the standard treatment of breast cancer following the pioneering studies by Halsted, early in the 20th century (Halsted, 1907). In the axlliary lymph node negative breast cancer in old woman, the role of axillary dissection (AD) remained controversial (Deckers, 1991; Silverstein et al, 1994). There were no differences in overall survival or distant metastases in NSABP-04 when old woman with breast cancer were randomized to axillary dissection, axillary radiotherapy, or no axillary treatment (Fisher et al, 2002). We did this systematic review to assess the effectiveness and safety in AD versus no AD group of breast cancer in old woman We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. Conclusions: Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Axillary dissection is not well-indicated in old women with breast cancer
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