Evidence map›Paper›PMID 36917335›Full record

ArticleAnnals of surgical oncology2023

The Association Between Surgical Axillary Staging, Adjuvant Treatment Use and Survival in Older Women with Early Stage Breast Cancer: A Population-Based Study.

Matthew Castelo, Rinku Sutradhar, Neil Faught, Danilo Giffoni M M Mata, Ezra Hahn, Lena Nguyen, Lawrence Paszat, Danielle Rodin, Sabina Trebinjac, Cindy Fong and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 9% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Deep learning-based breast MRI for predicting axillary lymph node metastasis: a systematic review and meta-analysis.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025
    Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
  7. 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

11 authors at 3 institutions in 1 country.

Matthew CasteloDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Rinku SutradharInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Neil FaughtICES, Toronto, ON, Canada.
Danilo Giffoni M M MataDepartment of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada.
Ezra HahnDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Lena NguyenICES, Toronto, ON, Canada.
Lawrence PaszatInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Danielle RodinDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Sabina TrebinjacDepartment of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Cindy FongICES, Toronto, ON, Canada.
Eileen RakovitchICES, Toronto, ON, Canada. eileen.rakovitch@sunnybrook.ca.
University of Toronto · CASunnybrook Health Science Centre · CALondon Health Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChoosing Wisely guidelines recommend against surgical axillary staging (AS) in women ≥70 years with ER+/HER2- early stage breast cancer (BC). This study examined the impact of AS omission on survival in older patients with BC.

methodsThis was a population-based cohort study using health administrative data in Ontario, Canada. We identified women aged 65-95 years who underwent surgery for Stage I/II BC between 2010 and 2016. Patients were weighted by propensity scores for receipt of AS that included patient and disease characteristics using overlap weights. Association with overall survival (OS) was calculated using weighted Cox models, and breast cancer-specific survival (BCSS) was calculated using weighted Fine and Gray models, adjusting for biomarkers and adjuvant treatments. Adjuvant treatment receipt was modelled with weighted log-binomial models.

resultsAmong 17,370 older women, the 1771 (10.2%) who did not undergo AS were older, more comorbid, and less likely to undergo mastectomy. Women who did not undergo AS were less likely to receive adjuvant chemotherapy (RR 0.68, 95% CI 0.57-0.82), endocrine therapy (RR 0.85, 95% CI 0.81-0.89) or radiotherapy (RR 0.69, 95% CI 0.65-0.74). After weighting and adjustment, there was no significant difference in BCSS (sdHR 0.98, 95% CI 0.77-1.25), but women who did not undergo AS had worse OS (HR 1.14, 95% CI 1.04-1.25). The results among 6215 ER+/HER2- women ≥70 years undergoing SLNB vs no AS were similar.

conclusionsThe omission of AS in older women with early stage BC was not associated with adverse BCSS, although OS was worse.

Indexed as

Breast NeoplasmsAdjuvants, ImmunologicAgedBreastCohort StudiesFemaleHumansMastectomyNeoplasm StagingOntarioAdjuvants, Immunologic

Identifiers

PMID36917335
OpenAlexW4324128611

What OpenQuestion holds

Textmetadata
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.