Evidence map›Paper›PMID 24516019›Full record

GuidelineJournal of clinical oncology : official journal of the American Society of Clinical Oncology2014

Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer.

Meena S Moran, Stuart J Schnitt, Armando E Giuliano, Jay R Harris, Seema A Khan, Janet Horton, Suzanne Klimberg, Mariana Chavez-MacGregor, Gary Freedman, Nehmat Houssami and 4 more

2 registry-linked trialsAbstract readMeta-AnalysisPractice GuidelineSystematic Review
PubMed Publisher
In one paragraph

Guideline in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 182 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
182citing papers in PubMed, 13 pooled it
16.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02386371 nacompletednot on this map

Feasibility Clinical Trial of Intraoperative Radiotherapy (IORT) and Second Breast-conserving-surgery After Local Recurrence of Breast Carcinoma

TypeinterventionalSponsorInstitut du Cancer de Montpellier - Val d'AurelleRan2014 to 2023Enrolled66ConditionsBreast CarcinomaArmstumorectomy, Intra Operative Radiotherapy
NCT05708664 nacompletednot on this mapstarted 2021, after this paper: background citation

Precision Breast Conserving Surgery With the Guidance of Localization Combined With Multidetector CT 3-dimensional Image Reconstruction: a Single Center, Prospective, Cohort Study.

TypeinterventionalSponsorThe First Affiliated Hospital with Nanjing Medical UniversityRan2021 to 2023Enrolled92ConditionsBreast CancerArmsprecision breast conserving surgery guided by wire guided localization combined with MDCT guided 3D reconstruction
3 · Its place in the literature

Who cites it

182 citing papers in PubMed, 13 syntheses or guidelines pooled it, 425 citations in OpenAlex.

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122 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Meena S MoranMeena S. Moran, Yale University School of Medicine, New Haven, CT; Stuart J. Schnitt and Jay R. Harris, Harvard Medical School, Boston, MA; Armando E. Giuliano, Cedars Sinai Medical Center, Los Angeles, CA; Seema A. Khan, Northwestern University Feinberg School of Medicine, Chicago, IL; Janet Horton, Duke University Medical Center, Durham, NC; Suzanne Klimberg, University of Arkansas for Medical Sciences, Fayetteville, AR; Mariana Chavez-MacGregor, University of Texas MD Anderson Cancer Center, Houston, TX; Gary Freedman, University of Pennsylvania School of Medicine, Philadelphia, PA; Nehmat Houssami, School of Public Health, University of Sydney Medical School, Sydney, New South Wales, Australia; Peggy L. Johnson, Susan G. Komen Advocate in Science, Wichita, KS; and Monica Morrow, Memorial Sloan-Kettering Cancer Center, New York, NY.
Stuart J Schnitt
Armando E Giuliano
Jay R Harris
Seema A Khan
Janet Horton
Suzanne Klimberg
Mariana Chavez-MacGregor
Gary Freedman
Nehmat Houssami
Peggy L Johnson
Monica Morrow
Society of Surgical Oncology
American Society for Radiation Oncology
Northwestern University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeControversy exists regarding the optimal margin width in breast-conserving surgery for invasive breast cancer.

methodsA multidisciplinary consensus panel used a meta-analysis of margin width and ipsilateral breast tumor recurrence (IBTR) from a systematic review of 33 studies including 28,162 patients as the primary evidence base for consensus.

resultsPositive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with a two-fold increase in the risk of IBTR compared with negative margins. This increased risk is not mitigated by favorable biology, endocrine therapy, or a radiation boost. More widely clear margins do not significantly decrease the rate of IBTR compared with no ink on tumor. There is no evidence that more widely clear margins reduce IBTR for young patients or for those with unfavorable biology, lobular cancers, or cancers with an extensive intraductal component.

conclusionThe use of no ink on tumor as the standard for an adequate margin in invasive cancer in the era of multidisciplinary therapy is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcomes, and decrease health care costs. J Clin Oncol 32. 2014 American Society of Clinical Oncology®, American Society for Radiation Oncology®, and Society of Surgical Oncology®. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology.

Indexed as

Breast NeoplasmsFemaleHumansMastectomy, SegmentalNeoplasm InvasivenessNeoplasm StagingRadiation Oncology

Identifiers

PMID24516019
OpenAlexW2153076843

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.