Table 1.
(A) Characteristics of ultrasound included studies | |||||||||||||
Author | Year | Country | Index Test | Second Test | Reference Standard | Prospective/Retrospective | N Analysed | N with Axillary Metastases | Prevalence of Axillary Metastases | Mean Age | Years of Study | Other Criteria | |
Chang W. [23] | 2018 | China | US | US + Elastosonography | Histology (SLNB/ALND) | Retrospective | 140 | 78 | 55.7% | 55.3 | 2013–2014 | Disjunctive method | |
Wallis M.G. [24] | 2017 | UK | US | US + CNB | Histology (SLNB/ALND) | Retrospective | 769 | 134 | 17.4% | ND | 2008–2015 | ||
Zhao Q.L. [25] | 2017 | China | US | US + Elastosonography | Histology (SLNB/ALND) | Prospective | 78 | 44 | 56.4% | 52.5 | 2012–2013 | Disjunctive method | |
Akinci M. [26] | 2016 | Turkey | US | US + FNA | Histology (SLNB/ALND) | Prospective | 46 | 30 | 65.2% | ND | 2011–2013 | ||
Gipponi M. [27] | 2016 | Italy | US | US + FNA | Histology (SLNB/ALND) | Prospective | 400 | 127 | 31.8% | 64.6 | 2013–2015 | Only T1-T2-T3 tumors | |
Zhu Y. [28] | 2016 | China | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 445 | 169 | 38.0% | 55.6 | 2013–2014 | Only T1-T2 tumors | |
Hyun S.J. [29] | 2015 | South Korea | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 497 | 159 | 32.0% | 52 | 2012–2013 | ||
Zhang Y.N. [30] | 2015 | China | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 1049 | 402 | 38.3% | 50.3 | 2010–2011 | ||
Sohn Y.M.b[31] | 2014 | South Korea | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 107 | 45 | 42.1% | 53.9 | 2009–2012 | ||
Cools Lartique J. [32] | 2013 | Canada | US | US + FNA | Histology (SLNB/ALND) | Prospective | 234 | 90 | 38.5% | 57.8 | 2005–2007 | ||
Stachs A. [33] | 2013 | Germany | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 470 | 166 | 35.3% | ND | 2008–2010 | ||
Riegger C. [34] | 2012 | Germany | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 91 | 37 | 40.7% | 55.5 | 2007–2010 | ||
Davey P. [35] | 2011 | Northern Ireland | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 119 | 40 | 33.6% | ND | 2009 | ||
Schiettecatte A. [36] | 2011 | Belgium | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 147 | 67 | 45.6% | 56 | ND | Breast tumors < 3cm | |
Baruah B.P. [37] | 2010 | UK | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 502 | 137 | 27.3% | 61 | 2006–2009 | ||
Jung J. [38] | 2010 | South Korea | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 189 | 61 | 32.3% | ND | 2005–2006 | ||
Luparia A. [39] | 2010 | Italy | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 427 | 170 | 39.8% | 60.9 | 2005–2008 | ||
Monzawa S. [40] | 2009 | Japan | US | US grayscale | Histology (SLNB/ALND) | Retrospective | 50 | 15 | 30.0% | 59 | 2005–2006 | ||
Cowher M.S. [41] | 2008 | USA | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 125 | 57 | 45.6% | 61.3 | 2004–2005 | ||
Moore A. [42] | 2008 | USA | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 112 | 58 | 51.8% | ND | ND | High risk of metastases | |
Ueda S. [43] | 2008 | Japan | US | US grayscale | Histology (SLNB/ALND) | Prospective | 183 | 59 | 32.2% | 57 | 2005–2007 | ||
Altomare V. [44] | 2007 | Italy | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 100 | 30 | 30.0% | 53 | 2004–2005 | Only T1-T2-T3 tumors. FNA performed for all patients | |
Davis J.T. [45] | 2006 | USA | US | US + FNA | Histology (SLNB/ALND) | Prospective | 37 | 22 | 59.5% | ND | 2004–2005 | High risk of metastases | |
Lumachi F. [46] | 2006 | Italy | US | US grayscale | Histology (SLNB/ALND) | Prospective | 77 | 37 | 48.1% | 54 | ND | Only T1-T2 tumors. | |
Popli M.B. [47] | 2006 | India | US | US + FNA | Histology (SLNB/ALND) | Prospective | 30 | 22 | 73.3% | ND | ND | ||
Podkrajsek M. [48] | 2005 | Slovenia | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 165 | 65 | 39.4% | 56 | 2001–2003 | ||
Bedrosian I. [49] | 2003 | USA | US | US + FNA | Histology (SLNB/ALND) | Prospective | 208 | 53 | 25.5% | 55.4 | 1994–2000 | ||
Deurloo E.E. [50] | 2003 | The Netherlands | US | US + FNA | Histology (SLNB/ALND) | Prospective | 268 | 121 | 45.1% | 56 | 1999–2001 | Only patients eligible for SLNB | |
Kuenen-Boumeester V. [51] | 2003 | The Netherlands | US | US + FNA | Histology (SLNB/ALND) | Retrospective | 183 | 85 | 46.4% | ND | 1998–2003 | ||
Sapino A. [52] | 2003 | Italy | US | US + FNA | Histology (SLNB/ALND) | Prospective | 298 | 88 | 29.5% | ND | 2000 | 31 in situ breast cancer | |
TOTAL | 7546 | 2668 | 35.4% | 56 | |||||||||
(B) Characteristics of Magnetic Resonance Imaging included studies | |||||||||||||
Author | Year | Country | Index Test | Second Test | Number of Testla | Reference Standard | Prospective/Retrospective | N Analysed | N with Axillary Metastases | Prevalence of Axillary Metastases | MEAN AGE | Period of Study | Other Criteria |
Kim S.H. [53] | 2017 | South Korea | MRI | With and without DWI + Gadolinium IV | 3T | Histology | Retrospective | 149 | 50 | 33.6% | 49.2 | 2014–2015 | |
(SLNB/ALND) | |||||||||||||
Yun S.J. [54] | 2016 | South Korea | MRI | With DWI + Gadolinium IV | 3T | Histology | Retrospective | 124 | 34 | 27.4% | 59.8 | 2011–2014 | |
(SLNB/ALND) | |||||||||||||
Schipper R.J. [55] | 2015 | The Netherlands | MRI | With and without DWI | 3T | Histology | Retrospective | 50 | 12 | 24.0% | 60 | 2012–2013 | Only T1-T2-T3 |
(SLNB/ALND) | tumors | ||||||||||||
Ergul N. [56] | 2015 | Turkey | MRI | With and without DWI | 1.5T | Histology | Prospective | 24 | 15 | 62.5% | 47 | 2012–2013 | Only T1-T2 |
(SLNB/ALND) | tumors | ||||||||||||
Kamitani T. [57] | 2013 | Japan | MRI | DWI alone | 1.5T | Histology | Retrospective | 110 | 26 | 23.6% | 54.9 | 2006–2007 | |
(SLNB/ALND) | |||||||||||||
Fornasa F. [58] | 2012 | Italy | MRI | With DWI + Gadolinium IV | 1.5T | Histology | Prospective | 43 | 19 | 44.2% | 58 | 2008–2010 | |
(SLNB/ALND) | |||||||||||||
Scaranelo M. [59] | 2012 | Canada | MRI | With and without DWI | 1.5T | Histology | Prospective | 65 | 28 | 43.1% | 53 | 2008–2009 | |
(SLNB/ALND) | |||||||||||||
Memarsadeghi M. [60] | 2006 | Austria | MRI | Without DWI + USPIO IV | 1T | Histology | Prospective | 22 | 6 | 27.3% | 62 | 5 months | |
(SLNB/ALND) | |||||||||||||
Michel S.C. [61] | 2002 | Switzerland | MRI | Without DWI + USPIO IV | 1.5T | Histology | Prospective | 18 | 11 | 61.1% | 53 | 2000–2001 | |
(SLNB/ALND) | |||||||||||||
Murray A.D. [62] | 2002 | UK | MRI | Without DWI + Gadolinium IV | 0.95T | Histology | ND | 47 | 10 | 21.3% | 63 | ND | |
(SLNB/ALND) | |||||||||||||
TOTAL | 652 | 211 | 32.4% | 55.4 | |||||||||
(C) Characteristics of FDG Positron Emission Tomography included studies | |||||||||||||
Author | Year | Country | Index Test | Second Test | Evaluation | Reference Standard | Prospective/Retrospective | N Analysed | N with Axillary Metastases | Prevalence of Axillary Metastases | Mean Age | Years of Study | Other Criteria |
Ergul N. [56] | 2015 | Turkey | FDG PET | With CT | Visual and semi-quantitative | Histology | Prospective | 24 | 15 | 62.5% | 47 | 2012–2013 | Only T1-T2 tumors |
(SLNB/ALND) | |||||||||||||
Jeong Y.J. [63] | 2014 | South Korea | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 178 | 48 | 27.0% | 54.9 | 2010–2013 | |
(SLNB/ALND) | |||||||||||||
Park J. [64] | 2014 | South Korea | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 136 | 70 | 51.5% | 49.7 | 2009–2012 | 3 patients without FDG-avid breast tumors excluded |
(SLNB/ALND) | |||||||||||||
Sohn Y.M. [31] | 2014 | South Korea | FDG PET | With CT | Visual | Histology | Retrospective | 107 | 45 | 42.1% | 53.9 | 2009–2012 | |
(SLNB/ALND) | |||||||||||||
Machida Y. [65] | 2013 | Japan | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 227 | 54 | 23.8% | ND | 2005–2009 | |
(SLNB/ALND) | |||||||||||||
Seok J.W. [66] | 2013 | South Korea | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 104 | 21 | 20.2% | 49.4 | 2010–2012 | Only T1-T2 tumors |
(SLNB/ALND) | |||||||||||||
Hahn S. [67] | 2012 | Germany | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 38 | 16 | 26.9% | 52 | 2008 | Only T1-T2 tumors |
(SLNB/ALND) | |||||||||||||
Riegger C. [34] | 2012 | Germany | FDG PET | With CT | Visual | Histology | Retrospective | 91 | 37 | 40.7% | 55.5 | 2007–2010 | |
(SLNB/ALND) | |||||||||||||
Choi W.H. [68] | 2011 | South Korea | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 171 | 73 | 42.7% | 50.1 | 2003–2006 | |
(SLNB/ALND) | |||||||||||||
Heusner T.A. [69] | 2009 | Germany | FDG PET | With CT | Visual | Histology | Retrospective | 61 | 24 | 39.3% | 56 | 2007–2008 | |
(SLNB/ALND) | |||||||||||||
Kim J [70] | 2009 | South Korea | FDG PET | With CT | Visual | Histology | Prospective | 137 | 35 | 25.5% | 50.5 | 2007–2008 | Only T1-T2 tumors |
(SLNB/ALND) | |||||||||||||
Monzawa S. [40] | 2009 | Japan | FDG PET | With CT | Visual | Histology | Retrospective | 50 | 15 | 30.0% | 59 | 2005–2006 | |
(SLNB/ALND) | |||||||||||||
Taira N. [71] | 2008 | Japan | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 92 | 27 | 29.3% | 54.6 | 2006–2007 | |
(SLNB/ALND) | |||||||||||||
Ueda S. [43] | 2008 | Japan | FDG PET | With CT | Visual | Histology | Prospective | 183 | 59 | 32.2% | 57 | 2005–2007 | |
(SLNB/ALND) | |||||||||||||
Veronesi U. [72] | 2007 | Italy | FDG PET | With CT | Visual and semi-quantitative | Histology | Retrospective | 236 | 103 | 43.6% | 49 | 2003–2005 | Only T1-T2-T3 tumors |
(SLNB/ALND) | |||||||||||||
Kumar R. [73] | 2006 | USA | FDG PET | Without CT | ND | Histology | Prospective | 80 | 36 | 45.0% | 52 | ND | |
(SLNB/ALND) | |||||||||||||
Weir L. [74] | 2005 | Canada | FDG PET | Without CT | Visual | Histology | Retrospective | 40 | 18 | 45.0% | 52 | 2000–2003 | |
(SLNB/ALND) | |||||||||||||
Fehr M.K. [75] | 2004 | Switzerland | FDG PET | Without CT | Visual | Histology | Prospective | 24 | 10 | 41.7% | 56 | ND | Tumors |
(SLNB/ALND) | < 3 cm (clinical) | ||||||||||||
Zornoza M.J. [76] | 2004 | Spain | FDG PET | Without CT | Visual | Histology | Prospective | 200 | 107 | 53.5% | 52.2 | ND | Tumors < 3.5 cm (ND) |
(SLNB/ALND) | |||||||||||||
Barranger E. [77] | 2003 | France | FDG PET | Without CT | Visual | Histology | Prospective | 32 | 15 | 46.9% | 58 | 2001 | Only T1-T2 tumors |
(SLNB/ALND) | |||||||||||||
Guller U. [78] | 2002 | Switzerland | FDG PET | Without CT | ND | Histology | Prospective | 31 | 14 | 45.2% | 64.8 | ND | |
(SLNB/ALND) | |||||||||||||
Nakamoto Y. [79] | 2002 | USA | FDG PET | Without CT | Visual | Histology | Prospective | 36 | 15 | 41.7% | 50.6 | ND | |
(SLNB/ALND) | |||||||||||||
Rieber A. [80] | 2002 | Germany | FDG PET | Without CT | ND | Histology | Retrospective | 40 | 20 | 50.0% | 52.9 | ND | |
(SLNB/ALND) | |||||||||||||
Van der Hoeven J.M. [81] | 2002 | The Netherlands | FDG PET | Without CT | Visual | Histology (SLNB/ALND) | Prospective | 70 | 32 | 45.7% | 58 | 1997–2000 | |
TOTAL | 2388 | 909 | 38.1% | 52.9 | |||||||||
(D) Characteristics of Fine Needle Aspiration included studies | |||||||||||||
Author | Year | Country | Index Test | Evaluation | Prospective/Retrospective? | N Analysed | N with Axillary Metastases | Prevalence of Axillary Metastases | Mean Age | Years of Studies | Other Criteria | ||
Zhu Y. [28] | 2016 | China | FNA | Histology | Retrospective | 445 | 169 | 38.0% | 55.6 | 2013–2014 | Only T1-T2 tumors | ||
(SLNB/ALND) | |||||||||||||
Sohn Y.M. [31] | 2014 | South Korea | FNA | Histology | Retrospective | 107 | 45 | 42.1% | 53.9 | 2009–2012 | |||
(SLNB/ALND) | |||||||||||||
Ganott M.A. [82] | 2014 | USA | FNA | Histology | Prospective | 44 | 26 | 59.1% | ND | 2008–2010 | |||
(SLNB/ALND) | |||||||||||||
Hayes B.D. [83] | 2011 | Ireland | FNA | Histology | Retrospective | 161 | 86 | 53.4% | ND | 2006–2009 | |||
(SLNB/ALND) | |||||||||||||
Schiettecatte A. [36] | 2011 | Belgium | FNA | Histology | Retrospective | 147 | 67 | 45.6% | 56 | ND | |||
(SLNB/ALND) | |||||||||||||
Luparia A. [39] | 2010 | Italy | FNA | Histology | Retrospective | 427 | 170 | 39.8% | 60.9 | 2005–2008 | FNA was not performed for all suspicious axillary US | ||
(SLNB/ALND) | |||||||||||||
Tahir M. [84] | 2008 | UK | FNA | Histology | Prospective | 38 | 17 | 44.7% | 56.7 | 2005–2006 | |||
(SLNB/ALND) | |||||||||||||
Cowher M.S. [41] | 2008 | USA | FNA | Histology | Retrospective | 125 | 57 | 45.6% | 61.3 | 2004–2005 | |||
(SLNB/ALND) | |||||||||||||
Moore A. [42] | 2008 | USA | FNA | Histology | Retrospective | 112 | 58 | 51.8% | ND | ND | Only high risk of metastases | ||
(SLNB/ALND) | |||||||||||||
Davis J.T. [45] | 2006 | USA | FNA | Histology | Prospective | 37 | 22 | 59.5% | ND | 2004–2005 | Only high risk of metastases | ||
(SLNB/ALND) | |||||||||||||
Popli M.B. [47] | 2006 | India | FNA | Histology | Prospective | 30 | 22 | 73.3% | ND | ND | |||
(SLNB/ALND) | |||||||||||||
Podkrajsek M. [48] | 2005 | Slovenia | FNA | Histology | Retrospective | 165 | 65 | 39.4% | 56 | 2001–2003 | |||
(SLNB/ALND) | |||||||||||||
Deurloo E.E. [50] | 2003 | The Netherlands | FNA | Histology | Prospective | 268 | 121 | 45.1% | 56 | 1999–2001 | |||
(SLNB/ALND) | |||||||||||||
Sapino A. [52] | 2003 | Italy | FNA | Histology | Prospective | 298 | 88 | 29.5% | ND | 2000 | |||
(SLNB/ALND) | |||||||||||||
TOTAL | 2404 | 1013 | 42.1% | 49.9 |
ALND: Axillary Lymph Nodes Dissection; SLNB: Sentinel Lymph Node Biopsy; CNB: Core Needle Biopsy; FNA: Fine Needle Aspiration; DWI: Diffusion Weighted Imaging; IV: Intravenous injection; MRI: Magnetic Resonance Imaging; CT: Computed Tomography; FDG: Fluorodeoxyglucose; PET: Positron Emission Tomography; USPIO: Ultrasmall Superparamagnetic Iron Oxide; US: Ultrasonography; N: Number of patients; ND: Not Determined; UK: United Kingdom; USA: United States of America.