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Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol

Goyal, Amit; Duley, Lelia; Fakis, Apostolos

Axillary treatment for patients with early breast cancer and lymph node metastasis: systematic review protocol Thumbnail


Amit Goyal

Lelia Duley

Apostolos Fakis


Background: For patients with early breast cancer and lymph node metastasis, axillary treatment is widely recommended. This is either surgical removal of the axillary lymph nodes, or axillary radiotherapy. The rationale for axillary treatment is that it will reduce the risk of recurrence in the axilla, and may improve survival. However, both treatments are associated with adverse effects, such as lymphedema, pain and sensory loss, and are costly to the health services and to patients. With improvements in adjuvant therapy, routine axillary treatment may no longer offer any overall advantage.

Objectives: To assess the short and long term benefits and adverse effects of routine axillary treatment (axillary lymph node clearance or axillary radiotherapy) for patients with lymph node positive early-stage breast cancer.

Methods/Design: Criteria for potentially eligibility for the study will be that the participants are men and women with early breast cancer and lymph nodes with metastasis. The study compares either axillary treatment with no axillary treatment, or axillary node clearance with axillary radiotherapy, and the study is a randomized trial. Primary outcomes are axillary recurrence, disease-free and overall survival. Secondary outcomes include breast or chest wall recurrence, distant metastasis, time to axillary recurrence, axillary recurrence-free survival, arm morbidity, quality of life and health economic costs. The search strategy will include the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and WHO International Clinical Trials Registry Platform (ICTRP) search portal. Two independent reviewers will assess studies for inclusion in the review, assess study quality and extract data. Characteristics of included studies will be described. Meta-analysis will be conducted using ReVman software.

Comment: This review addresses an important clinical question, and results will inform clinical practice and health care policy.

Journal Article Type Article
Publication Date Jan 14, 2013
Deposit Date Apr 10, 2014
Publicly Available Date Apr 10, 2014
Journal World Journal of Surgical Oncology
Electronic ISSN 1477-7819
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 11
Issue 6
Article Number 6
Public URL
Publisher URL


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