Evidence map›Paper›PMID 38683499›Full record

ReviewLa Radiologia medica2024

Management of the axilla in breast cancer patients: critical review, regional modified Delphi consensus and implementation in the Tuscan breast network.

Matteo Ghilli, Carlotta Becherini, Icro Meattini, Catia Angiolini, Carmelo Bengala, Aroldo Marconi, Lorenzo Galli, Giovanni Angiolucci, Luigi Coltelli, Simona Borghesi and 8 more

Abstract readReviewConsensus Statement
PubMed Publisher
In one paragraph

Review in La Radiologia medica, 2024. 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
–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

1 citing paper in PubMed.

  1. Review
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

18 authors.

Matteo Ghilli *Breast Centre, Breast Surgery, University Hospital of Pisa, Via Roma 67, Pisa, Italy. m.ghilli@ao-pisa.toscana.it.ORCID http://orcid.org/0000-0001-5536-7377
Carlotta Becherini *Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Icro MeattiniRadiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Catia AngioliniBreast Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, A. Brambilla 3, 50134, Florence, Italy.
Carmelo BengalaOncology Department, Unit of Medical Oncology, Misericordia Hospital, Grosseto, Italy.
Aroldo MarconiBreast Oncological and Reconstructive Surgery, S.Luca Hospital- V. G. Lippi Francesconi, 55100, Lucca, Italy.
Lorenzo GalliAzienda Usl Toscana Centro, Ospedale San Giovanni Di Dio, Via Di Torregalli N 3, 50143, Florence, Italy.
Giovanni AngiolucciRadiologia Senologica, Azienda Usl Toscana Sud-Est, Ospedale Arezzo, Giovanni Valdarno, Italy.
Luigi ColtelliDivision of Medical Oncology, Livorno Hospital, Department of Oncology, Azienda USL Toscana Nord Ovest, Viale Alfieri 36, Leghorn, Italy.
Simona BorghesiDepartment of Radiation Oncology, Azienda Usl Toscana Sud-Est, Ospedale Arezzo E S., Giovanni Valdarno, Italy.
Luciana LastrucciDepartment of Radiation Oncology, Livorno Hospital, Azienda USL Toscana Nord Ovest, Viale Alfieri 36, Leghorn, Italy.
Gianpiero MancaBreast Centre, Nuclear Medicine, University Hospital of Pisa, Via Roma 67, Pisa, Italy.
Simonetta BianchiDepartment of Health Sciences, Division of Pathological Anatomy, University of Florence, Viale Pieraccini 6, Florence, Italy.
Morena DoriaSOC Anatomia Patologica, Azienda Usl Toscana Centro, Ospedale San Giovanni Di Dio, Via Di Torregalli N° 3, 50143, Florence, Italy.
Donato CasellaBreast Unit AOUS Siena, Siena, Italy.
Lorenza MarottiEuropean Society of Breast Cancer Specialists, Florence, Italy.
Gianni AmunniAzienda Ospedaliero Universitaria Careggi, Florence, Italy.
Manuela RoncellaBreast Centre, Breast Surgery, University Hospital of Pisa, Via Roma 67, Pisa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeData from recently trials have provided practice-changing recommendations in management of the axilla in early breast cancer (eBC). However, further controversies have been raised, resulting in heterogeneous diffusion of these recommendations. Our purpose was to obtain a better homogeneity. MATERIAL AND

methodsIn 2021, the Tuscan Breast Network (TBN) established a consensus with the aim to update recommendations in this area. We performed a literature review on axillary management in eBC patients which led to an expert Delphi consensus aiming to explore the gray areas, build consensus and propose evidence-based suggestions for an appropriate management. Thereafter, we investigate their implementation in clinical practice.

results(1) DCIS patients should have SLN biopsy only in case of mastectomy or in conservative surgery if tumor is in a location that would preclude future nodal sampling or in case of a mass; (2) ALND may be omitted for 1-2 positive SLN patients undergoing BCS in T1-2 tumors with 1-2 SLN positive, eligible for whole-breast irradiation and adjuvant systemic therapies; (3) consider the option of RNI in patients with 1-3 positive lymph nodes and one or more high-risk characteristics; (4) the population identified in 2) should NOT undergo lymph node irradiation as an alternative to axillary surgery and (5) patients with clinically (pre-operatively) positive axilla, or undergoing primary systemic therapy, or outside the criteria reported in 2) must receive additional ALND and/or RT as per local policy.

conclusionThis consensus provided a practical tool to stimulate local and national breast surgical and radiotherapy protocols.

Indexed as

AxillaBreast NeoplasmsDelphi TechniqueFemaleHumansItalyLymphatic MetastasisLymph Node ExcisionMastectomySentinel Lymph Node BiopsyAxillary managementBreast cancerBreast cancer surgeryDelphi consensusGuidelinesPositive sentinel node

Identifiers

PMID38683499

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.