ArticleGeburtshilfe und Frauenheilkunde2017
Restricted Axillary Staging in Clinically and Sonographically Node-Negative Early Invasive Breast Cancer (c/iT1-2) in the Context of Breast Conserving Therapy: First Results Following Commencement of the Intergroup-Sentinel-Mamma (INSEMA) Trial.
Article in Geburtshilfe und Frauenheilkunde, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02466737 (Comparison of Axillary Sentinel Lymph Node Biopsy Versus no Axillary Surgery in Patients With Early-stage Invasive Breast Cancer and Breast-conserving Surgery), which is not on this map. Cited by 74 papers, 4 of them syntheses that pooled 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.
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.
Comparison of Axillary Sentinel Lymph Node Biopsy Versus no Axillary Surgery in Patients With Early-stage Invasive Breast Cancer and Breast-conserving Surgery: a Randomized Prospective Surgical Trial. Intergroup-Sentinel-Mamma (INSEMA)-Trial
Who cites it
74 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Deep learning-based breast MRI for predicting axillary lymph node metastasis: a systematic review and meta-analysis.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Pooled it
- Uncertainties and controversies in axillary management of patients with breast cancer.Cancer treatment reviews · 2023Pooled it
- Axillary dissection versus axillary observation for low risk, clinically node-negative invasive breast cancer: a systematic review and meta-analysis.Breast cancer (Tokyo, Japan) · 2021Pooled it
- Incorporating Percutaneous Laser Ablation for Early Breast Cancer Treatment: A Systematic Review.Technology in cancer research & treatmentPooled it
- Preservation of Axillary Lymph Nodes Compared with Complete Dissection in T1-2 Breast Cancer Patients Presenting One or Two Metastatic Sentinel Lymph Nodes: The SINODAR-ONE Multicenter Randomized Clinical Trial.Annals of surgical oncology · 2022Trial
- Mathematical Prediction Models for Sentinel Node Status in Early-Stage Breast Cancer: Protocol for a Systematic Review.JMIR research protocols · 2026Article
- Risk stratification system for sentinel lymph node metastasis in clinically node-negative early breast cancer with sonographically abnormal but cytologically negative axilla.Scientific reports · 2025Article
- Surgical management of breast cancer: a review.Annals of medicine and surgery (2012) · 2025Review
- Should abemaciclib candidacy be an indication for ALND?-commentary on SENOMAC post-hoc analysis.Gland surgery · 2025Article
- Review
- Preoperative comprehensive risk estimation for axillary lymph node metastasis in breast cancer: development and verification of a network-based prediction model.Scientific reports · 2025Article
- Omitting sentinel lymph node biopsy in early breast cancer: too bold or the future?Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Article
- Identification of sentinel lymph node macrometastasis in breast cancer by deep learning based on clinicopathological characteristics.Scientific reports · 2024Article
- Omission of axillary surgery in cN0, postmenopausal ER-positive/HER2-negative breast cancer patients undergoing breast-conserving treatment.Gland surgery · 2024Article
- Article
- Assessment of the axilla in women with early-stage breast cancer undergoing primary surgery: a review.World journal of surgical oncology · 2024Review
- Comparison of long-term outcome between clinically high risk lobular versus ductal breast cancer: a propensity score matched study.EClinicalMedicine · 2024Article
- De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1-2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07).The British journal of surgery · 2024Article
- Health-related quality of life (HRQoL) after different axillary treatments in women with breast cancer: a 1-year longitudinal cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Axillary lymph node status remains an important prognostic factor in early breast cancer. It is regarded as an indicator for (neo)adjuvant systemic treatment and postoperative radiotherapy of the regional lymphatics. Commenced in September 2015, the INSEMA trial is investigating whether operative determination of nodal status as part of breast conserving therapy (BCT) for early stage breast cancer (c/iT1-2 c/iN0) can be avoided without reducing oncological safety. After inclusion of 1001 patients there was general acceptance of the complex study design by patients and study doctors so that recruitment for the first randomisation (axillary sentinel lymph node biopsy [SLNB]: yes or no) achieved predicted case numbers. The second randomisation however (SLNB alone versus complete axillary dissection when one or two macrometastases are present at SLNB) recruited fewer cases than expected for the following three reasons: a) the 13 % rate of one or two macrometastases after SLNB in the INSEMA trial collective was lower than expected; b) around 20 % of patients refused the second randomisation; c) there was delayed inclusion of the Austrian study centres, which only recruited for the second randomisation. Lack of knowledge of nodal status when SLNB is avoided represents a new challenge for the postoperative tumour board. In particular decisions on chemotherapy for luminal-like tumours and irradiation of the lymphatics (excluding axilla) must be guided by tumour biological parameters. The INSEMA trial does not provide answers to some important questions, e.g. it remains unclear whether patients without SLNB can be offered partial breast irradiation alone in low-risk situations and whether SLNB can also be avoided in patients with stage T1-2 tumours who have a mastectomy indication.
Indexed as
Identifiers
What OpenQuestion holds
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.