Evidence map›Paper›PMID 37458948›Full record

ArticleAnnals of surgical oncology2023

Extremely Low Incidence of Local-Regional Recurrences Observed Among T1-2 N1 (1 or 2 Positive SLNs) Breast Cancer Patients Receiving Upfront Mastectomy Without Completion Axillary Node Dissection.

Shruti Zaveri, Shlermine Everidge, Elizabeth FitzSullivan, Rosa Hwang, Benjamin D Smith, Heather Lin, Yu Shen, Anthony Lucci, Mediget Teshome, Susie X Sun and 2 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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Shruti ZaveriDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Shlermine EveridgeDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Elizabeth FitzSullivanDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Rosa HwangDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Benjamin D SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Heather LinDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Yu ShenDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Anthony LucciDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Mediget TeshomeDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Susie X SunDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Kelly K HuntDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Henry M KuererDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. hkuerer@mdanderson.org.

Funding

U OF TEXAS HLTH SCI CTR HOUSTON CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCESUL1RR024148 · NCRR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2006 to 2010
$27.9M
NCRR NIH HHS UL1 RR024148
6 · The paper itself

Abstract

backgroundCompletion axillary node dissection (CLND) is routinely omitted in cT1-2 N0 breast cancer treated with upfront, breast-conserving therapy and sentinel node biopsy (SLNB) showing one to two positive sentinel nodes (SLNs). The purpose of this study was to determine the incidence and impact of axillary treatment among patients treated with mastectomy in a contemporary cohort.

methodsA prospective, institutional database was reviewed from 2006 to 2015 to identify patients with T1-2 breast cancer treated with upfront mastectomy and SLNB found to have one to two positive SLNs. Patients were stratified by axillary therapy [including CLND and/or post-mastectomy radiation therapy (PMRT)], and clinicopathologic factors and incidence rates of local-regional and distant recurrence were analyzed.

resultsA total of 548 patients were identified, including 126 (23%) without CLND. Rates of PMRT were similar between those with and without CLND (35.3% vs. 28.6%, p = 0.16). On multivariate analysis, two rather than one positive SLN, larger SLN metastasis size, frozen-section analysis of the SLNB, and adjuvant chemotherapy were significantly associated with receipt of CLND. At a median follow-up of 7 years, there were only two local-regional recurrences in the no-CLND group, of which only one was an axillary recurrence. The 5-years incidence rate of LRR was not significantly different for those with and without CLND (1.3% vs. 1.8%, p = 0.93).

conclusionsWe found extremely low rates of local-regional recurrence among those with T1-2 breast cancer undergoing upfront mastectomy with 1-2 positive SLNs. Further axillary surgery may not be indicated in selected patients treated with a multidisciplinary approach, including adjuvant therapies.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularLymph Node ExcisionMastectomyNeoplasm Recurrence, LocalSentinel Lymph NodeAdultAgedAxillaFemaleFollow-Up StudiesHumansIncidenceLymphatic MetastasisMiddle Aged

Identifiers

PMID37458948

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.