Evidence map›Paper›PMID 30361873›Full record

ReviewBreast cancer research and treatment2019

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis.

Michael M Jonczyk, Jolie Jean, Roger Graham, Abhishek Chatterjee

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Breast cancer research and treatment, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 8 pooled it
13.7field-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.

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

95 citing papers in PubMed, 8 syntheses or guidelines pooled it, 221 citations in OpenAlex.

  1. Pooled it
  2. SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (UPDATE 2025).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Guideline
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  7. SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (2022).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023
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35 more citing papers are in PubMed but not listed here.

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

4 authors at 2 institutions in 1 country.

Michael M JonczykDepartment of Surgery, Tufts Medical Center, 800 Washington Street, South Building, 4th Floor, Boston, MA, 02111, USA. mjonczyk@tuftsmedicalcenter.org.ORCID http://orcid.org/0000-0003-2507-6813
Jolie JeanTufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA.
Roger GrahamDepartment of Surgery, Tufts Medical Center, 800 Washington Street, South Building, 4th Floor, Boston, MA, 02111, USA.
Abhishek ChatterjeeDepartment of Plastic Surgery, Tufts Medical Center, 800 Washington Street, South Building, 4th Floor, Boston, MA, 02111, USA.
Tufts Medical Center · USTufts University · US

Funding

CTSA Graduate ProgramTL1TR002546 · NCATS · TUFTS UNIVERSITY BOSTON · PI KENT, DAVID M · 2018 to 2022
$4.2M
National Center for Advancing Translational Sciences TL1TR002546NCATS NIH HHS TL1 TR002546
6 · The paper itself

Abstract

purposeBreast cancer surgical techniques are evolving. Few studies have analyzed national trends for the multitude of surgical options that include partial mastectomy (PM), mastectomy without reconstruction (M), mastectomy with reconstruction (M+R), and PM with oncoplastic reconstruction (OS). We hypothesize that the use of M is declining and likely correlates with the rise of surgery with reconstructive options (M+R, OS).

methodsA retrospective cohort analysis was conducted using the ACS-NSQIP database from 2005 to 2016 and ICD codes for IBC and DCIS. Patients were then grouped together based on current procedural terminology (CPT) codes for PM, M, M+R, and OS. In each group, categories were sorted again based on additional reconstructive procedures. Data analysis was conducted via Pearson's chi-squared test for demographics, linear regression, and a non-parametric Mann- Kendall test to assess a temporal trend.

resultsThe patient cohort consisted of 256,398 patients from the NSQIP data base; 197,387 meet inclusion criteria diagnosed with IBC or DCIS. Annual breast surgery trends changed as follows: PM 46.3-46.1% (p = 0.21), M 35.8-26.4% (p = 0.001), M+R 15.9-23.0% (p = 0.03), and OS 1.8-4.42% (p = 0.001). Analyzing the patient cohort who underwent breast conservation, categorical analysis showed a decreased use of PM alone (96-91%) with an increased use of OS (4-9%). For the patient cohort undergoing mastectomy, M alone decreased (69-53%); M+R with muscular flap decreased (9-2%); and M+R with implant placement increased (20-40%)-all three trends p < 0.0001.

conclusionThe modern era of breast surgery is identified by the increasing use of reconstruction for patients undergoing breast conservation (in the form of OS) and mastectomy (in the form of M+R). Our study provides data showing significant trends that will impact the future of both breast cancer surgery and breast training programs.

Indexed as

BreastBreast NeoplasmsDatabases, FactualFemaleHumansMammaplastyMastectomyBreast conservation surgeryBreast reconstructionMastectomySurgical incidenceTrend analysis

Identifiers

PMID30361873
PMCPMC6486837
OpenAlexW2898458326

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.