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Abstract：
BACKGROUND: Sentinel lymph node biopsy (SLNB) is commonly used in the surgical management of male breast cancer. Contrary to female breast cancer, limited data exist about its performance in male breast cancer. The objective of this systematic review and meta-analysis was to evaluate the SLNB accuracy in male breast cancer.
METHODS: MEDLINE, EMBASE, Web of Science and The Cochrane Library were searched from January 1995 to April 2023 for studies evaluating the SLNB identification rate and false-negative rate in male breast cancer with negative preoperative axillary evaluation and primary surgery. For SLNB false-negative rate, the gold standard was the histology of axillary lymph node dissection (ALDN). Methodological quality was assessed by using the QUADAS-2 tool. Pooled estimates of the SLNB identification rate and false-negative rate were calculated. Heterogeneity of the pooled studies was evaluated using I2 index.
RESULTS: A total of 12 retrospective studies were included. The 12 studies that reported the SLNB identification rate gathered a total of 164 patients; the 5 studies that reported the SLNB false-negative rate gathered a total of 50 patients with a systematic ALND. The pooled estimate of the SLNB identification rate was 99.0%. The SLNB false-negative rates were 0% in the 5 included studies and consequently so as the pooled estimate of the false-negative rate with no heterogeneity.
CONCLUSIONS: SLNB for male breast cancer, following negative preoperative axillary assessment and primary surgery, appears feasible, consistent, and effective. Our research supports conducting immediate SLNB histological evaluation to facilitate prompt ALND in case of positive results.
METHODS: MEDLINE, EMBASE, Web of Science and The Cochrane Library were searched from January 1995 to April 2023 for studies evaluating the SLNB identification rate and false-negative rate in male breast cancer with negative preoperative axillary evaluation and primary surgery. For SLNB false-negative rate, the gold standard was the histology of axillary lymph node dissection (ALDN). Methodological quality was assessed by using the QUADAS-2 tool. Pooled estimates of the SLNB identification rate and false-negative rate were calculated. Heterogeneity of the pooled studies was evaluated using I2 index.
RESULTS: A total of 12 retrospective studies were included. The 12 studies that reported the SLNB identification rate gathered a total of 164 patients; the 5 studies that reported the SLNB false-negative rate gathered a total of 50 patients with a systematic ALND. The pooled estimate of the SLNB identification rate was 99.0%. The SLNB false-negative rates were 0% in the 5 included studies and consequently so as the pooled estimate of the false-negative rate with no heterogeneity.
CONCLUSIONS: SLNB for male breast cancer, following negative preoperative axillary assessment and primary surgery, appears feasible, consistent, and effective. Our research supports conducting immediate SLNB histological evaluation to facilitate prompt ALND in case of positive results.
摘要：
背景：前哨淋巴结活检（SLNB）通常用于男性乳腺癌的外科治疗。与女性乳腺癌相反，关于其在男性乳腺癌中的表现的数据有限。本系统评价和荟萃分析的目的是评估男性乳腺癌的SLNB准确性。
方法：MEDLINE，EMBASE,从1995年1月至2023年4月，对WebofScience和Cochrane图书馆进行了搜索，以评估术前腋窝评估和初次手术均为阴性的男性乳腺癌的SLNB识别率和假阴性率。对于SLNB假阴性率，金标准是腋窝淋巴结清扫术(ALDN)的组织学.使用QUADAS-2工具评估方法学质量。计算SLNB识别率和假阴性率的集合估计。使用I2指数评估合并研究的异质性。
结果：共纳入12项回顾性研究。报告SLNB识别率的12项研究共收集了164名患者；报告SLNB假阴性率的5项研究共收集了50名系统性ALND患者。SLNB识别率的汇总估计为99.0%。在纳入的5项研究中，SLNB的假阴性率为0％，因此是对假阴性率的汇总估计，没有异质性。
结论：SLNB用于男性乳腺癌，在术前腋窝评估阴性和初次手术后，似乎可行，一致,而且有效。我们的研究支持立即进行SLNB组织学评估，以在阳性结果的情况下促进ALND。
方法：MEDLINE，EMBASE,从1995年1月至2023年4月，对WebofScience和Cochrane图书馆进行了搜索，以评估术前腋窝评估和初次手术均为阴性的男性乳腺癌的SLNB识别率和假阴性率。对于SLNB假阴性率，金标准是腋窝淋巴结清扫术(ALDN)的组织学.使用QUADAS-2工具评估方法学质量。计算SLNB识别率和假阴性率的集合估计。使用I2指数评估合并研究的异质性。
结果：共纳入12项回顾性研究。报告SLNB识别率的12项研究共收集了164名患者；报告SLNB假阴性率的5项研究共收集了50名系统性ALND患者。SLNB识别率的汇总估计为99.0%。在纳入的5项研究中，SLNB的假阴性率为0％，因此是对假阴性率的汇总估计，没有异质性。
结论：SLNB用于男性乳腺癌，在术前腋窝评估阴性和初次手术后，似乎可行，一致,而且有效。我们的研究支持立即进行SLNB组织学评估，以在阳性结果的情况下促进ALND。
