Evidence map›Paper›PMID 39048903›Full record

Observational studyAnnals of surgical oncology2024

The Prevalence of Sentinel Lymph Node Positivity and Implications for the Utility of Frozen Section Diagnosis Following Neoadjuvant Systemic Therapy in Patients with Clinically Node-Negative HER2-Positive or Triple-Negative Breast Cancer.

Kerollos Nashat Wanis, Lianna Goetz, Alycia So, Alexa C Glencer, Susie X Sun, Mediget Teshome, Erika Resetkova, Rosa F Hwang, Kelly K Hunt, Rosalind P Candelaria and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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. Observational
  2. Article
  3. 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.

Kerollos Nashat Wanis *Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Lianna Goetz *Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Alycia SoDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Alexa C GlencerDepartment 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.
Mediget TeshomeDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Erika ResetkovaDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Rosa F HwangDepartment 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.
Rosalind P CandelariaDepartment of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Lei HuoDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. LeiHuo@mdanderson.org.
Puneet SinghDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. puneetsinghmd@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAxillary dissection is the standard of care for patients with positive sentinel lymph nodes (SLNs) following neoadjuvant systemic therapy. Frozen section can provide intraoperative information regarding the need for axillary dissection during the index operation. However, there are limited data on the utility of frozen section in patients with clinically node-negative (cN0) HER2-positive or triple-negative breast cancer.

methodsWe conducted a single-institution observational cohort study including patients with non-inflammatory, cN0, HER2-positive or triple-negative breast cancer treated with neoadjuvant systemic therapy between 2015 and 2019. We estimated the prevalence of SLN positivity and the diagnostic test characteristics of SLN frozen section.

resultsOverall, 662 patients were eligible for inclusion, and 44 patients had one or more positive SLNs (prevalence: 6.6%, 95% confidence interval [CI] 4.9-8.8). There were 490 (74.0%) patients who had intraoperative frozen section, and 19 (3.9%) tested positive among 33 (6.7%) with positive final pathology. Frozen section sensitivity was 57.6% (95% CI 39.2-74.5), specificity was 100% (95% CI 99.2-100), positive predictive value was 100% (95% CI 82.4-100), and negative predictive value was 97.0% (95% CI 95.1-98.4). The sensitivity of frozen section for detection of micrometastases or isolated tumor cells was 35.3% (95% CI 14.2-61.7).

conclusionIn patients with cN0 HER2-positive or triple-negative breast cancer who have been treated with neoadjuvant therapy, positive SLNs are uncommon and frozen section sensitivity is modest. Decisions to defer SLN evaluation to final pathology, which may be reasonable in many settings, can be informed, in part, by these findings.

Indexed as

Erb-b2 Receptor Tyrosine KinasesFrozen SectionsNeoadjuvant TherapySentinel Lymph NodeSentinel Lymph Node BiopsyTriple Negative Breast NeoplasmsAdultAgedAged, 80 and overBreast NeoplasmsFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph Node ExcisionMiddle AgedERBB2 protein, humanErb-b2 Receptor Tyrosine Kinases

Identifiers

PMID39048903

What OpenQuestion holds

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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.