The value of sentinel lymph-node biopsy in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy: a systematic review

PURPOSE

To conduct a systematic review to analyse the performance of the sentinel lymph-node biopsy (SLNB) in women with node-positive breast cancer at diagnosis and node-negative tumour after neoadjuvant therapy, compared to axillary lymph-node dissection.

METHODS

The more relevant databases were searched. Main outcomes were false-negative rate (FNR), sentinel lymph-node identification rate (SLNIR), negative predictive value (NPV), and accuracy. We conducted meta-analyses when appropriate.

RESULTS

Twenty studies were included. The pooled FNR was 0.14 (95% CI 0.11-0.17), the pooled SLNIR was 0.89 (95% CI 0.86-0.92), NPV was 0.83 (95% CI 0.79-0.87), and summary accuracy was 0.92 (95% CI 0.90-0.94). SLNB performed better when more than one node was removed and double mapping was used.

CONCLUSIONS

SLNB can be performed in women with a node-negative tumour after neoadjuvant therapy. It has a better performance when used with previous marking of the affected node and with double tracer.

Eligibility criteria for menopausal hormone therapy (MHT): A consortium of scientific societies for the use of MHT in women with medical conditions. Research protocol

The objective of this project is to create eligibility criteria for the use of menopausal hormone therapy (MHT) similar to those established for contraceptive methods. A consortium of scientific societies coordinated by the Spanish Menopause Society met to formulate recommendations for the use of MHT by patients with medical conditions based on the best available evidence. The project protocol, which was registered in the Open Science Framework platform (DOI 10.17605/OSF.IO/J6WBC), will be conducted in two phases. As a first step we will conduct a series of systematic reviews on the safety of MHT, addressing eight clinical questions. The findings of these systematic reviews will help to inform a structured process in which a panel of experts will define the eligibility criteria according to a specific framework, which will facilitate the discussion and development process. For the first time, a set of eligibility criteria, based on clinical evidence and developed according to the most rigorous methodological tools, will be defined. This will provide health professionals with a powerful decision-making tool that can be used in the management of menopausal symptoms.

A nursing qualitative systematic review required MEDLINE and CINAHL for study identification

OBJECTIVE

Analyze the number and the relevance of references retrieved from CINAHL, MEDLINE, and EMBASE to perform a nursing systematic review.

STUDY DESIGN

A search strategy for the review topic was designed according to thesaurus terms. The study analyzes (1) references with abstract, (2) overlap between databases, (3) reference relevance, (4) relevance agreement between experts, and (5) reference accessibility.

RESULTS

Bibliographic search retrieved 232 references: 16% (37) in CINAHL, 68% (157) in MEDLINE, and 16% (38) in EMBASE. Of these, 72% (164) were references retrieved with an abstract: 14% (23) in CINAHL, 70% (115) in MEDLINE, and 16% (26) in EMBASE. Overlap was observed in 2% (5) of the references. Relevance assessment reduced the number of references to 43 (19%): 12 (34.3%) in CINAHL, 31 (19.7%) in MEDLINE, and none in EMBASE (Z=-1.97; P=.048). Agreement between experts achieved a maximum Cohen's kappa of 0.76 (P < .005). References identified in CINAHL were the most difficult to obtain (chi(2)=3.9; df=1; P=.048).

CONCLUSIONS

To perform a quality bibliographic search for a systematic review on nursing topics, CINAHL and MEDLINE are essential databases for consultation to maximize the accuracy of the search.