Evidence map›Paper›PMID 30197937›Full record

ArticleAdvances in radiation oncology

A component of lobular carcinoma in clinically lymph node-negative patients predicts for an increased likelihood of upstaging to pathologic stage III breast cancer.

Renae D Van Wyhe, Abigail S Caudle, Simona F Shaitelman, George H Perkins, Thomas A Buchholz, Karen E Hoffman, Eric A Strom, Benjamin D Smith, Welela Tereffe, Wendy A Woodward and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 54% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

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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

11 authors at 2 institutions in 1 country.

Renae D Van WyheDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abigail S CaudleDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Simona F ShaitelmanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
George H PerkinsDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Thomas A BuchholzDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Karen E HoffmanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Eric A StromDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Benjamin D SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Welela TereffeDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Wendy A WoodwardDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Michael C StauderDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
The University of Texas MD Anderson Cancer Center · USBaylor College of Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePhysical examination and diagnostic imaging are often less precise in determining the extent of disease in invasive lobular carcinoma (ILC) relative to nonlobular histologies. Anecdotally, surgical axillary evaluation frequently reveals positive lymph nodes in clinically N0 patients with ILC; however, few studies quantify the likelihood of finding unsuspected disease at the time of surgery. In this study, we evaluate whether the presence of lobular histology increases the incidence of surgical upstaging to pathologic stage IIIA or greater in patients with a clinically node-negative axilla and positive sentinel lymph node (SLN) biopsy. METHODS AND MATERIALS: We examined patients from our institution between 1997 and 2009 treated specifically with mastectomy, SLN biopsy, and completion axillary lymph node dissection due to a positive SLN. For analysis, patients were grouped according to the presence of any lobular component on surgical pathology. The number of total positive lymph nodes, cancer stage, age, final tumor size, and ER/PR/HER2 status were assessed based on tumor histology.

resultsWe evaluated 345 previously untreated women with clinical T0-T2 and N0 disease at the time of surgery. A total of 110 patients (32%) had a component of ILC on surgical pathology. In addition, 295 patients (85.5%) had ER + breast carcinoma, 243 (70.4%) had PR + disease, 56 (16.2%) were HER2 + , and 28 (8.1%) were triple negative. At the time of surgery, women with lobular disease were observed to have a greater number of positive lymph nodes (2.79 vs 2.26;

conclusionsIn this cohort, patients with a component of lobular carcinoma were more often surgically upstaged to pathologic stage IIIA or higher, which is a classical indication for postmastectomy radiation therapy. Our findings suggest that ILC is often more extensive than it appears clinically and has significant implications for management of patients with lobular carcinoma after the discovery of a positive SLN.

Identifiers

PMID30197937
PMCPMC6127965
OpenAlexW2789649006

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.