Evidence map›Paper›PMID 36040640›Full record

ArticleBreast cancer research and treatment2022

Omission of axillary surgery for ipsilateral breast tumor recurrence with negative nodes after previous breast-conserving surgery: is it oncologically safe?

Fei-Lin Qu, Cai-Jin Lin, Zhe-Bin Liu, A-Yong Cao, Jiong Wu, Guang-Yu Liu, Ke-Da Yu, Gen-Hong Di, Jun-Jie Li, Zhi-Ming Shao

Open access · hybridAbstract read
In one paragraph

Article in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 50% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. 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

10 authors at 1 institution in 1 country.

Fei-Lin Qu *Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Cai-Jin Lin *Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Zhe-Bin LiuDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
A-Yong CaoDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Jiong WuDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Guang-Yu LiuDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Ke-Da YuDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Gen-Hong DiDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Jun-Jie LiDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. lijunjie5268@163.com.
Zhi-Ming ShaoDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. zhimin_shao@yeah.net.ORCID http://orcid.org/0000-0002-4503-148X
Shanghai Medical College of Fudan University · CN

Funding

Chinese Young Breast Experts Research project CYBER-2021-004
6 · The paper itself

Abstract

purposeSalvage mastectomy is traditionally recommended for patients who developed ipsilateral breast tumor recurrence (IBTR) in light of previous breast irradiation. However, it remains controversial whether surgical axillary staging (SAS) is necessary for IBTR patients with negative nodes. This study aimed to evaluate the oncologic safety of omitting SAS for IBTR.

methodsWe retrospectively identified patients who developed invasive IBTR with negative nodes after undergoing breast-conserving surgery (BCS) from 2010 to 2018. Patterns of care in nodal staging were analyzed based on prior axillary staging status. Clinicopathologic characteristics and adjuvant treatment of the initial tumor, as well as the IBTR, were compared between the SAS and no SAS groups. Kaplan-Meier method and Cox regression model were utilized to compare the locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS) rates after IBTR removal between the two groups.

resultsA total of 154 IBTR patients were eligible for final analysis. Compared to the no SAS group, SAS group was less likely to undergo ALND (15.1 vs 73.3%, p < 0.001) at initial BCS, had a longer recurrence interval (2.8 vs 2.1 years, p = 0.03), and were more likely to have discordant molecular subtype (35.8 vs 12.9%, p = 0.001) and different quadrant location (37.7 vs 19.8%, p = 0.02) with primary tumor. However, the extent of axillary staging did not affect systemic or radiation recommendations. In the subgroup of patients without previous ALND, the clinicopathologic characteristics were roughly comparable. No significant differences were observed in LRRFS, DMFS or OS between the two groups.

conclusionFor node-negative IBTR patients, we observed selection bias on the basis of prior ALND, shorter recurrence interval, and concordant molecular subtype favoring no SAS but comparable LRRFS, DMFS, and OS. These results support a wider consideration of sparing SAS in the management of IBTR, especially in patients without previous ALND.

Indexed as

Breast NeoplasmsMastectomy, SegmentalFemaleHumansMastectomyNeoplasm Recurrence, LocalRetrospective StudiesBreast cancerBreast-conserving surgeryIpsilateral breast tumor recurrenceSurgical axillary staging

Identifiers

PMID36040640
PMCPMC9550716
OpenAlexW4293769575

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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.