Evidence map›Paper›PMID 33688940›Full record

ArticleBJS open2021

Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer.

R V Dave, S Cheung, M Sibbering, O Kearins, J Jenkins, A Gandhi

Open access · goldAbstract read
In one paragraph

Article in BJS open, 2021. 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
0.2field-weighted citation impact, top 55% 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, 3 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 4 institutions in 1 country.

R V DaveThe Nightingale Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
S CheungNational Health Service Breast Screening Programme, Public Health England, Birmingham, UK.
M SibberingUniversity Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
O KearinsNational Health Service Breast Screening Programme, Public Health England, Birmingham, UK.
J JenkinsNational Health Service Breast Screening Programme, Public Health England, Birmingham, UK.
A GandhiThe Nightingale Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
National Health Service · GBManchester Academic Health Science Centre · GBUniversity Hospitals of Derby and Burton NHS Foundation Trust · GBWythenshawe Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen with screen-detected invasive breast cancer who have macrometastatic disease on axillary sentinel lymph node biopsy (SLNB) are usually offered either surgical axillary node clearance (ANC) or axillary radiotherapy. These treatments can lead to significant complications for patients. The aim of this study was to identify a group of patients who may not require completion ANC.

methodsData from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC.

resultsOf the 2401 women included in the cohort, the presence of non-sentinel node disease was significantly affected by: the number of nodes obtained at SLNB (odds ratio (OR) 0.49 for retrieval of more than 1 node), invasive size of tumour (OR 1.63 for size greater than 20 mm), surgical treatment (OR 1.34 for mastectomy), human epidermal growth factor receptor (HER) 2 status (OR 0.71 for HER2 positivity), and patient age (OR 1.10 for age less than 50 years; OR 1.46 for age greater than 70 years). Patients aged less than 70 years, with tumour size smaller than 2 cm, more than one node retrieved on SLNB, and who had breast-conserving surgery had a lower chance of positive non-sentinel nodes on completion ANC compared with other patients.

conclusionThis study, of a purely screen-detected breast cancer cohort, identified a subset of patients who may be spared completion ANC in the event of a single axillary SLN with macrometastasis.

Indexed as

Lymphatic MetastasisLymph Node ExcisionSentinel Lymph Node BiopsyTumor BurdenAgedAxillaBreast NeoplasmsEarly Detection of CancerFemaleHumansMammographyMass ScreeningMastectomyMastectomy, SegmentalMiddle AgedNeoplasm Invasiveness

Identifiers

PMID33688940
PMCPMC7944503
OpenAlexW3133800224

What OpenQuestion holds

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LicenceCC BY
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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.