Evidence map›Paper›PMID 29855831›Full record

ArticleAnnals of surgical oncology2018

Surgical Management of Lobular Carcinoma In Situ: Analysis of the National Cancer Database.

Lauren J Taylor, Jennifer Steiman, Jessica R Schumacher, Lee G Wilke, Caprice C Greenberg, Heather B Neuman

Open access · greenAbstract read
In one paragraph

Article in Annals of surgical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 40% 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.

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

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Lauren J TaylorDepartment of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI, USA.
Jennifer SteimanDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Jessica R SchumacherDepartment of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI, USA.
Lee G WilkeDepartment of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI, USA.
Caprice C GreenbergDepartment of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI, USA.
Heather B NeumanDepartment of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI, USA. neuman@surgery.wisc.edu.
University of Wisconsin–Madison · USUniversity of Pittsburgh · US

Funding

UW Surgical Oncology Research Training Program (UW-SORT)T32CA090217 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI Muhammed Murtaza, Heather B Neuman · 2001 to 2026
$8.3M
BUILDING INTERDISCIPLINARY RESEARCH CAREER IN WOMEN'S HEALTH (BIRCWH) SCHOLARSK12HD055894 · NICHD · UNIVERSITY OF WISCONSIN-MADISON · PI BURNSIDE, ELIZABETH S · 2007 to 2016
$4.1M
Mentored Training for Dissemination and Implemention Research in CancerR25CA171994 · NCI · WASHINGTON UNIVERSITY · PI BROWNSON, ROSS C · 2013 to 2017
$1.5M
National Cancer Institute R25CA171994National Cancer Institute T32CA090217NCI NIH HHS R25 CA171994NCI NIH HHS T32 CA090217NICHD NIH HHS K12 HD055894NIH HHS K12HD055894
6 · The paper itself

Abstract

backgroundCurrent guidelines recommend counseling on risk-reduction strategies, including lifestyle modification, endocrine therapy, and bilateral mastectomy, for patients with classic-type lobular carcinoma in situ (LCIS) detected on core biopsy or surgical excision. Importantly, current diagnosis and treatment guidelines for classic-type LCIS do not include unilateral mastectomy for primary treatment or risk reduction. Prior studies reporting national practice patterns suggest increasing use of mastectomy for management of LCIS, with considerable variation by geographic region. However, these studies did not distinguish between uni- and bilateral mastectomies. This study aimed to investigate national practice patterns and factors associated with unilateral mastectomy.

methodsThe study used the National Cancer Database to identify women with a diagnosis of LCIS from 2004 to 2013. Descriptive statistics were used to describe surgical treatment, and multinomial logistic regression was used to identify temporal, patient, and facility-level factors associated with receipt of uni- and bilateral mastectomy.

resultsThe study identified 30,105 women with LCIS. Of these woman, 5.4% received no surgery, 84.8% had surgical excision, 4% underwent unilateral mastectomy, and 5.1% underwent bilateral mastectomy. Adjusted analysis showed that young age, white race, insurance coverage, greater comorbidity, and geographic region (p < 0.001) were associated with receipt of both uni- and bilateral mastectomy. Additionally, more recent year of diagnosis was associated with receipt of bilateral mastectomy. Unilateral mastectomy rates within geographic regions ranged from 2.7% in New England to 8% in the South.

conclusionsNearly as many patients underwent unilateral (4%) as bilateral mastectomy (5.1%), representing inappropriate care. These findings highlight an opportunity to reduce unnecessary care through improved provider and patient education regarding optimal management of LCIS.

Indexed as

Databases, FactualMastectomyAdultAgedAged, 80 and overBiopsy, Large-Core NeedleBreast Carcinoma In SituBreast NeoplasmsCarcinoma, LobularDisease ManagementFemaleFollow-Up StudiesHumansMiddle AgedPrognosisYoung Adult

Identifiers

PMID29855831
PMCPMC6030479
OpenAlexW2807429950

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.