Evidence map›Paper›PMID 39044106›Full record

ArticleAnnals of surgical oncology2024

Residual Nodal Burden After Neoadjuvant Chemotherapy in cN1 Breast Cancer Patients with Positive Nodes at Targeted Axillary Dissection.

Alexandra M Moore, Abigail S Caudle, Susie X Sun, Min Yi, Benjamin D Smith, Vicente Valero, Wei Yang, Henry M Kuerer, Kelly K Hunt, Mediget Teshome

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
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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

10 authors.

Alexandra M MooreDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. alexandra.mc.moore@gmail.com.
Abigail S CaudleDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Susie X SunDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Min YiDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Benjamin D SmithDepartment of Breast Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Vicente ValeroDepartment of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Wei YangDepartment of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Henry M KuererDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Kelly K HuntDepartment of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Mediget TeshomeDepartment of Surgery, Division of Surgical Oncology, University of California Los Angeles, Los Angeles, CA, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundTargeted axillary dissection (TAD) facilitates nodal staging in cN1 breast cancer after neoadjuvant chemotherapy (NAC). Completion axillary node dissection (cALND) remains the standard of care for TAD-positive patients. This study investigated factors associated with additional positive nodes at cALND (cALND+) and the impact on the residual cancer burden (RCB).

methodsRetrospective review of cN1 breast cancer patients treated with NAC and TAD was conducted from July 2013 to June 2023. The review defined cN1 status by ultrasound (US) and biopsy. Patient, tumor, and treatment characteristics were evaluated. Multivariate analysis was performed to identify factors associated with cALND+, and RCB was calculated.

resultsOf 902 patients who underwent TAD, 554 (61.4%) were TAD-positive. 457 underwent cALND, and 124 (27%) were cALND+ (average 4.1 additional +nodes). The cALND+ patients had larger primary tumors at diagnosis (4 vs 3.5 cm; p = 0.04), more than three suspicious nodes on initial US (30% vs 13%; p ≤ 0.0001), larger residual primary tumors on pathology (median, 3 vs 2.1 cm; p = 0.0004), and more positive TAD nodes (median, 2 vs 1; p ≤ 0.0001). In the multivariate analysis, the factors associated with cALND+ were more than three suspicious nodes on initial US (odds ratio [OR], 2.9; p ≤ 0.0001), more positive TAD nodes (OR, 1.1; p ≤ 0.0001), larger clipped node metastasis (OR, 1.1; p ≤ 0.0001), and larger residual tumor on pathology (OR, 1.1; p = 0.006). Of 65 cALND+ patients with RCB class I or II, 29 (45%) had an increase in RCB based on cALND.

conclusionOf cN1 breast cancer patients treated with NAC who are TAD-positive, approximately 25% will have additional nodal disease on cALND. In these patients, positive cALND is associated with greater disease burden, which has potential implications for RCB status and prognosis.

Indexed as

AxillaBreast NeoplasmsLymph Node ExcisionLymph NodesNeoadjuvant TherapyNeoplasm, ResidualAdultAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansLymphatic MetastasisMiddle AgedPrognosisBreast cancerCompletion axillary dissectionNeoadjuvant chemotherapyNode-positiveTargeted axillary dissection

Identifiers

PMID39044106
PMCPMC12335219

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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.