Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

A. Zada, M.C.L. Peek, M. Ahmed, B. Anninga, R. Baker, M. Kusakabe, M. Sekino, J.M. Klaase, Bernard ten Haken, M. Douek

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Abstract

Background The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to identify and excise sentinel lymph nodes. A systematic review and meta-analysis was performed to assess the performance and utility of the magnetic in comparison to the standard technique. Methods MEDLINE, PubMed, Embase and the Cochrane online literature databases were used to identify all original articles evaluating the magnetic technique for SLNB published up to April 2016. Studies were included if they were prospectively conducted clinical trials comparing the magnetic with the standard technique for SLNB in patients with breast cancer. Results Seven studies were included. The magnetic technique was non-inferior to the standard technique (z = 3·87, P < 0·001), at a 2 per cent non-inferiority margin. The mean identification rates for the standard and magnetic techniques were 96·8 (range 94·2–99·0) and 97·1 (94·4–98·0) per cent respectively (risk difference (RD) 0·00, 95 per cent c.i. –0·01 to 0·01; P = 0·690). The total lymph node retrieval was significantly higher with the magnetic compared with the standard technique: 2113 (1·9 per patient) versus 2000 (1·8 per patient) (RD 0·05, 0·03 to 0·06; P = 0·003). False-negative rates were 10·9 (range 6–22) per cent for the standard technique and 8·4 (2–22) per cent for the magnetic technique (RD 0·03, 0·00 to 0·06; P = 0·551). The mean discordance rate was 3·9 (range 1·7–6·9) per cent. Conclusion The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.
Original languageEnglish
Pages (from-to)1409-1419
JournalBritish journal of surgery
Volume103
Issue number11
DOIs
Publication statusPublished - 30 Jun 2016

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Sentinel Lymph Node Biopsy
Breast Neoplasms
Lymph Nodes
Clinical Trials
PubMed
Meta-Analysis
Coloring Agents
Databases

Keywords

  • METIS-317765
  • IR-101126

Cite this

Zada, A., Peek, M. C. L., Ahmed, M., Anninga, B., Baker, R., Kusakabe, M., ... Douek, M. (2016). Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. British journal of surgery, 103(11), 1409-1419. https://doi.org/10.1002/bjs.10283
Zada, A. ; Peek, M.C.L. ; Ahmed, M. ; Anninga, B. ; Baker, R. ; Kusakabe, M. ; Sekino, M. ; Klaase, J.M. ; ten Haken, Bernard ; Douek, M. / Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. In: British journal of surgery. 2016 ; Vol. 103, No. 11. pp. 1409-1419.
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abstract = "Background The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to identify and excise sentinel lymph nodes. A systematic review and meta-analysis was performed to assess the performance and utility of the magnetic in comparison to the standard technique. Methods MEDLINE, PubMed, Embase and the Cochrane online literature databases were used to identify all original articles evaluating the magnetic technique for SLNB published up to April 2016. Studies were included if they were prospectively conducted clinical trials comparing the magnetic with the standard technique for SLNB in patients with breast cancer. Results Seven studies were included. The magnetic technique was non-inferior to the standard technique (z = 3·87, P < 0·001), at a 2 per cent non-inferiority margin. The mean identification rates for the standard and magnetic techniques were 96·8 (range 94·2–99·0) and 97·1 (94·4–98·0) per cent respectively (risk difference (RD) 0·00, 95 per cent c.i. –0·01 to 0·01; P = 0·690). The total lymph node retrieval was significantly higher with the magnetic compared with the standard technique: 2113 (1·9 per patient) versus 2000 (1·8 per patient) (RD 0·05, 0·03 to 0·06; P = 0·003). False-negative rates were 10·9 (range 6–22) per cent for the standard technique and 8·4 (2–22) per cent for the magnetic technique (RD 0·03, 0·00 to 0·06; P = 0·551). The mean discordance rate was 3·9 (range 1·7–6·9) per cent. Conclusion The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.",
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Zada, A, Peek, MCL, Ahmed, M, Anninga, B, Baker, R, Kusakabe, M, Sekino, M, Klaase, JM, ten Haken, B & Douek, M 2016, 'Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique' British journal of surgery, vol. 103, no. 11, pp. 1409-1419. https://doi.org/10.1002/bjs.10283

Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. / Zada, A.; Peek, M.C.L.; Ahmed, M.; Anninga, B.; Baker, R.; Kusakabe, M.; Sekino, M.; Klaase, J.M.; ten Haken, Bernard; Douek, M.

In: British journal of surgery, Vol. 103, No. 11, 30.06.2016, p. 1409-1419.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique

AU - Zada, A.

AU - Peek, M.C.L.

AU - Ahmed, M.

AU - Anninga, B.

AU - Baker, R.

AU - Kusakabe, M.

AU - Sekino, M.

AU - Klaase, J.M.

AU - ten Haken, Bernard

AU - Douek, M.

PY - 2016/6/30

Y1 - 2016/6/30

N2 - Background The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to identify and excise sentinel lymph nodes. A systematic review and meta-analysis was performed to assess the performance and utility of the magnetic in comparison to the standard technique. Methods MEDLINE, PubMed, Embase and the Cochrane online literature databases were used to identify all original articles evaluating the magnetic technique for SLNB published up to April 2016. Studies were included if they were prospectively conducted clinical trials comparing the magnetic with the standard technique for SLNB in patients with breast cancer. Results Seven studies were included. The magnetic technique was non-inferior to the standard technique (z = 3·87, P < 0·001), at a 2 per cent non-inferiority margin. The mean identification rates for the standard and magnetic techniques were 96·8 (range 94·2–99·0) and 97·1 (94·4–98·0) per cent respectively (risk difference (RD) 0·00, 95 per cent c.i. –0·01 to 0·01; P = 0·690). The total lymph node retrieval was significantly higher with the magnetic compared with the standard technique: 2113 (1·9 per patient) versus 2000 (1·8 per patient) (RD 0·05, 0·03 to 0·06; P = 0·003). False-negative rates were 10·9 (range 6–22) per cent for the standard technique and 8·4 (2–22) per cent for the magnetic technique (RD 0·03, 0·00 to 0·06; P = 0·551). The mean discordance rate was 3·9 (range 1·7–6·9) per cent. Conclusion The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.

AB - Background The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to identify and excise sentinel lymph nodes. A systematic review and meta-analysis was performed to assess the performance and utility of the magnetic in comparison to the standard technique. Methods MEDLINE, PubMed, Embase and the Cochrane online literature databases were used to identify all original articles evaluating the magnetic technique for SLNB published up to April 2016. Studies were included if they were prospectively conducted clinical trials comparing the magnetic with the standard technique for SLNB in patients with breast cancer. Results Seven studies were included. The magnetic technique was non-inferior to the standard technique (z = 3·87, P < 0·001), at a 2 per cent non-inferiority margin. The mean identification rates for the standard and magnetic techniques were 96·8 (range 94·2–99·0) and 97·1 (94·4–98·0) per cent respectively (risk difference (RD) 0·00, 95 per cent c.i. –0·01 to 0·01; P = 0·690). The total lymph node retrieval was significantly higher with the magnetic compared with the standard technique: 2113 (1·9 per patient) versus 2000 (1·8 per patient) (RD 0·05, 0·03 to 0·06; P = 0·003). False-negative rates were 10·9 (range 6–22) per cent for the standard technique and 8·4 (2–22) per cent for the magnetic technique (RD 0·03, 0·00 to 0·06; P = 0·551). The mean discordance rate was 3·9 (range 1·7–6·9) per cent. Conclusion The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.

KW - METIS-317765

KW - IR-101126

U2 - 10.1002/bjs.10283

DO - 10.1002/bjs.10283

M3 - Article

VL - 103

SP - 1409

EP - 1419

JO - British journal of surgery

JF - British journal of surgery

SN - 0007-1323

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Zada A, Peek MCL, Ahmed M, Anninga B, Baker R, Kusakabe M et al. Meta‐analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. British journal of surgery. 2016 Jun 30;103(11):1409-1419. https://doi.org/10.1002/bjs.10283