Omission of axillary staging in elderly patients with early stage breast cancer impacts regional control but not survival: A systematic review and meta-analysis.
INTRODUCTION
Management of early breast cancer in the elderly population is challenging due to different breast cancer biology and limited tolerance to aggressive treatments. The aim of this study is to evaluate whether the omission of axillary staging impacts breast cancer outcomes in elderly patients.


PATIENTS AND METHODS
A systematic review and meta-analysis was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The electronic databases were searched in August 2014 using the following inclusion criteria: RESULTS: Two RCTs met the eligibility criteria and were included. A meta-analysis of the included RCTs of 692 patients found that axillary staging reduced the risk of axillary recurrence compared to no axillary staging (RR 0.24, 95% CI: 0.06 to 0.95, I2=0%, p=0.04). There were no differences observed in in-breast recurrence or distant recurrence (RR 1.20, 95% CI: 0.55 to 2.64, I2=62%, p=0.65, RR 1.17, 95% CI: 0.75 to 1.82, I2=0%, p=0.48, respectively). There were no differences observed in overall or breast-cancer specific mortality (RR 0.99, 95% CI: 0.79 to 1.24, I2=0%, p=0.92, RR 1.07, 95% CI: 0.72 to 1.57, I2=0%, p=0.75, respectively).


DISCUSSION
Omission of axillary staging in elderly patients with clinically negative axillae results in increased regional recurrence but does not appear to impact survival.
['Liang|Shuyin|S|', 'Hallet|Julie|J|', 'Simpson|Jory S|JS|', 'Tricco|Andrea C|AC|', 'Scheer|Adena S|AS|']
D000367:Age Factors D000368:Aged D001365:Axilla D001943:Breast Neoplasms D018572:Disease-Free Survival D055088:Early Detection of Cancer D005260:Female D006801:Humans D008197:Lymph Node Excision D008207:Lymphatic Metastasis D009367:Neoplasm Staging D016032:Randomized Controlled Trials as Topic D012008:Recurrence D012306:Risk D016896:Treatment Outcome
Axillary staging Elderly Breast cancer Systematic review Meta-analysis