SynthesisBMJ (Clinical research ed.)2022
Margin status and survival outcomes after breast cancer conservation surgery: prospectively registered systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05732064 (Effects of Low-dose Dexmedetomidine-esketamine Combined Nasal Administration at Night on Perioperative Sleep Quality in Breast Cancer Patients), which is not on this map. Cited by 89 papers, 6 of them syntheses that pooled 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.
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.
Effects of Low-dose Dexmedetomidine-esketamine Combined Nasal Administration at Night on Perioperative Sleep Quality in Breast Cancer Patients: a Randomized, Double-blind, Placebo-controlled Trial
Who cites it
89 citing papers in PubMed, 6 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Margin status, re-excision, and completion mastectomy after oncoplastic versus conventional breast-conserving surgery for breast cancer: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Development and Validation of an Ipsilateral Breast Tumor Recurrence Risk Estimation Tool Incorporating Real-World Data and Evidence From Meta-Analyses: A Retrospective Multicenter Cohort Study.JCO clinical cancer informatics · 2025Pooled it
- Oncological outcomes following extreme oncoplastic breast conserving surgery (eOPBCS) for locally advanced breast cancer (LABC): A systematic review and meta-analysis.Breast (Edinburgh, Scotland) · 2025Pooled it
- Hyperspectral imaging for tumor resection guidance in surgery: a systematic review of preclinical and clinical studies.Journal of biomedical optics · 2025Pooled it
- Fluorescence imaging for real-time detection of breast cancer tumors using IV injection of indocyanine green with non-conventional imaging: a systematic review of preclinical and clinical studies of perioperative imaging technologies.Breast cancer research and treatment · 2024Pooled it
- Specimen mammography for intraoperative margin assessment in breast conserving surgery: a meta-analysis.Scientific reports · 2022Pooled it
- Therapeutic mammoplasty in selected East Asian patients: oncologic safety and cosmetic outcomes.Breast cancer (Tokyo, Japan) · 2026Observational
- Article
- Highly cosmetic and safe breast-conserving surgery using a wave-like periareolar incision with sub-nipple and extensive subcutaneous dissection: a retrospective cohort study.Gland surgery · 2026Article
- Cavity Margins Sample Shaving as Part of Extended Vacuum-Assisted Breast Biopsy: A Potential Approach to Predict Percutaneous Breast Cancer Excision.Annals of surgical oncology · 2026Article
- Prognostic significance of positive margin-informed tumor status in esophageal squamous cell carcinoma using next-generation sequencing.The oncologist · 2026Article
- Specimen PET-CT Imaging for Intraoperative Margin Assessment in Early-Stage Breast Cancer: The BrIMA Nonrandomized Clinical Trial.JAMA surgery · 2026Article
- From Label-Free Multiphoton Imaging to Pathological Reports: A Vision-Language Breast Cancer Margin Pathological Diagnosis System.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Endoscopy‑assisted breast‑conserving treatment: the first Polish review of 30 patients.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026Article
- Label-free classification of breast cancer subtypes in ex vivo human tissues using Raman spectroscopy and machine learning.Scientific reports · 2026Article
- Intraoperative measurement of breast-conserving surgery margins: surgical application.Breast cancer research : BCR · 2026Review
- Analysis of low-benefit subgroups in breast-conserving surgery: Implications for clinical decision-making (Review).Experimental and therapeutic medicine · 2026Review
- Breast-Conserving Surgery After Neoadjuvant Chemotherapy Guided by a Supine Magnetic Resonance Imaging Projection Mapping System Visualizing Original Cancer Extent.Journal of breast cancer · 2026Article
- Article
- Cryoablation-guided breast-conserving surgery: a single-center, retrospective study based on a propensity score-matched cohort.Gland surgery · 2026Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine if margin involvement is associated with distant recurrence and to determine the required margin to minimise both local recurrence and distant recurrence in early stage invasive breast cancer.
designProspectively registered systematic review and meta-analysis of literature. DATA SOURCES: Medline (PubMed), Embase, and Proquest online databases. Unpublished data were sought from study authors. ELIGIBILITY CRITERIA: Eligible studies reported on patients undergoing breast conserving surgery (for stages I-III breast cancer), allowed an estimation of outcomes in relation to margin status, and followed up patients for a minimum of 60 months. Patients with ductal carcinoma in situ only or treated with neoadjuvant chemotherapy or by mastectomy were excluded. Where applicable, margins were categorised as tumour on ink (involved), close margins (no tumour on ink but <2 mm), and negative margins (≥2 mm).
results68 studies from 1 January 1980 to 31 December 2021, comprising 112 140 patients with breast cancer, were included. Across all studies, 9.4% (95% confidence interval 6.8% to 12.8%) of patients had involved (tumour on ink) margins and 17.8% (13.0% to 23.9%) had tumour on ink or a close margin. The rate of distant recurrence was 25.4% (14.5% to 40.6%) in patients with tumour on ink, 8.4% (4.4% to 15.5%) in patients with tumour on ink or close, and 7.4% (3.9% to 13.6%) in patients with negative margins. Compared with negative margins, tumour on ink margins were associated with increased distant recurrence (hazard ratio 2.10, 95% confidence interval 1.65 to 2.69, P<0.001) and local recurrence (1.98, 1.66 to 2.36, P<0.001). Close margins were associated with increased distant recurrence (1.38, 1.13 to 1.69, P<0.001) and local recurrence (2.09, 1.39 to 3.13, P<0.001) compared with negative margins, after adjusting for receipt of adjuvant chemotherapy and radiotherapy. In five studies published since 2010, tumour on ink margins were associated with increased distant recurrence (2.41, 1.81 to 3.21, P<0.001) as were tumour on ink and close margins (1.44, 1.22 to 1.71, P<0.001) compared with negative margins.
conclusionsInvolved or close pathological margins after breast conserving surgery for early stage, invasive breast cancer are associated with increased distant recurrence and local recurrence. Surgeons should aim to achieve a minimum clear margin of at least 1 mm. On the basis of current evidence, international guidelines should be revised. SYSTEMATIC REVIEW REGISTRATION: CRD42021232115.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.