Evidence map›Paper›PMID 29214416›Full record

SynthesisBreast cancer research and treatment2018

Breast-conserving surgery following neoadjuvant therapy-a systematic review on surgical outcomes.

José H Volders, Vera L Negenborn, Pauline E Spronk, Nicole M A Krekel, Linda J Schoonmade, Sybren Meijer, Isabel T Rubio, M Petrousjka van den Tol

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in Breast cancer research and treatment, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 47 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

José H VoldersDepartment of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Room 7F-020, 1081 HV, Amsterdam, The Netherlands.
Vera L NegenbornDepartment of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Pauline E SpronkDutch Institute for Clinical Auditing, Leiden, The Netherlands.
Nicole M A KrekelDepartment of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Linda J SchoonmadeMedical Library, VU University Amsterdam, Amsterdam, The Netherlands.
Sybren MeijerDepartment of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Room 7F-020, 1081 HV, Amsterdam, The Netherlands.
Isabel T RubioBreast Cancer Surgical Unit, Breast Cancer Center, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
M Petrousjka van den TolDepartment of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Room 7F-020, 1081 HV, Amsterdam, The Netherlands. mp.vandentol@vumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeoadjuvant chemotherapy (NACT) is increasingly used in breast cancer treatment. One of the main goals of NACT is to reduce the extent of local surgery of the breast and axilla. The aim of this study was to determine surgical outcomes for patients receiving breast-conserving therapy (BCT) after NACT, including margin status plus secondary surgeries, excision volumes, and cosmetic outcomes.

methodsA systematic review was performed in accordance with PRISMA principles. Pubmed, MEDLINE, Embase, and the Cochrane Library were searched for studies investigating the results of BCT following NACT. The main study outcomes were margin status, additional local therapies, excision volumes, and cosmetic outcomes. Non-comparative studies on NACT were also included. Exclusion criteria were studies with less than 25 patients, and studies excluding secondary mastectomy patients.

findingsOf the 1219 studies screened, 26 studies were deemed eligible for analysis, including data from 5379 patients treated with NACT and 10,110 patients treated without NACT. Included studies showed wide ranges of tumor-involved margins (2-39.8%), secondary surgeries (0-45.4%), and excision volumes (43.2-268 cm

interpretationThere is currently insufficient evidence to suggest that NACT improves surgical outcomes of BCT. It is imperative that clinical trials include patient outcome measures in order to allow monitoring and meaningful comparison of treatment outcomes in breast cancer.

Indexed as

Margins of ExcisionPatient SatisfactionAntineoplastic AgentsBreastBreast NeoplasmsEstheticsFemaleHumansMastectomy, SegmentalNeoadjuvant TherapyReoperationTreatment OutcomeAntineoplastic AgentsBreast-conserving therapyCosmetic outcomeExcision volumeMarginsNeoadjuvant chemotherapySecondary mastectomy

Identifiers

PMID29214416
PMCPMC5847047

What OpenQuestion holds

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Registered trials

None linked

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.