Evidence map›Paper›PMID 36212601›Full record

ArticleWorld journal of clinical oncology2022

Factors predicting upstaging from clinical N0 to pN2a/N3a in breast cancer patients.

Goshi Oda, Tsuyoshi Nakagawa, Hiroki Mori, Iichiro Onishi, Tomoyuki Fujioka, Mio Mori, Kazunori Kubota, Ryoichi Hanazawa, Akihiro Hirakawa, Toshiaki Ishikawa and 2 more

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

Article in World journal of clinical oncology, 2022. 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
0.3field-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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. The Evolution and Clinical Impact of Deep Learning Technologies in Breast MRI.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025
    Review
  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

12 authors at 1 institution in 1 country.

Goshi OdaDepartment of Breast Surgery, Tokyo Medical and Dental University, Tokyo 1138519, Japan. odasrg2@tmd.ac.jp.
Tsuyoshi NakagawaDepartment of Breast Surgery, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Hiroki MoriDepartment of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Iichiro OnishiDepartment of Pathology, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Tomoyuki FujiokaDepartment of Radiology, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Mio MoriDepartment of Radiology, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Kazunori KubotaDepartment of Radiology, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Ryoichi HanazawaDepartment of Clinical Biostatistics, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Akihiro HirakawaDepartment of Clinical Biostatistics, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Toshiaki IshikawaDepartment of Specialized Surgeries, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Kentaro OkamotoDepartment of Specialized Surgeries, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Hiroyuki UetakesszszDepartment of Specialized Surgeries, Tokyo Medical and Dental University, Tokyo 1138519, Japan.
Tokyo Medical and Dental University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith sentinel node metastasis in breast cancer (BC) patients, axillary lymph node (ALN) dissection is often omitted from cases with breast-conserving surgery. Omission of lymph node dissection reduces the invasiveness of surgery to the patient, but it also obscures the number of metastases to non-sentinel nodes. The possibility of finding ≥ 4 lymph nodes (pN2a/pN3a) preoperatively is important given the ramifications for postoperative treatment.

aimTo search for clinicopathological factors that predicts upstaging from N0 to pN2a/pN3a.

methodsPatients who were sentinel lymph node (SLN)-positive and underwent ALN dissection between September 2007 and August 2018 were selected by retrospective chart review. All patients had BC diagnosed preoperatively as N0 with axillary evaluation by fluorodeoxyglucose (FDG) positron emission tomography/computed tomography and ultrasound (US) examination. When suspicious FDG accumulation was found in ALN, the presence of metastasis was reevaluated by second US. We examined predictors of upstaging from N0 to pN2a/pN3a.

resultsAmong 135 patients, we identified 1-3 ALNs (pN1) in 113 patients and ³4 ALNs (pN2a/pN3a) in 22 patients. Multivariate analysis identified the total number of SLN metastasis, the maximal diameter of metastasis in the SLN (SLNDmax), and FDG accumulation of ALN as predictors of upstaging to pN2a/pN3a.

conclusionWe identified factors involved in upstaging from N0 to pN2a/pN3a. The SLNDmax and number of SLN metastasis are predictors of ≥ 4 ALNs (pN2a/pN3a) and predictors of metastasis to non-sentinel nodes, which have been reported in the past. Attention should be given to axillary accumulations of FDG, even when faint.

Indexed as

Axillary lymph node metastasisBreast cancerDiameter of sentinel lyphonode metastasisPositron emission tomography/computed tomographyPredictive factors of lymphnode metastasisSentinel lymph nodeStandardized uptake value max

Identifiers

PMID36212601
PMCPMC9537504
OpenAlexW4296755317

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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.