Evidence map›Paper›PMID 39402322›Full record

ArticleAnnals of surgical oncology2024

Real-World Implications of the SOUND Trial.

Andreas Giannakou, Olga Kantor, Ko Un Park, Adrienne G Waks, Rinaa S Punglia, Laura S Dominici, Faina Nakhlis, Elizabeth A Mittendorf, Tari A King

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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 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

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

  1. Pooled it
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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

9 authors.

Andreas GiannakouDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Olga KantorDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Ko Un ParkDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Adrienne G WaksBreast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Rinaa S PungliaBreast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Laura S DominiciDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Faina NakhlisDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Elizabeth A MittendorfDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Tari A KingDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. tking7@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe SOUND trial demonstrated that omission of sentinel lymph node biopsy (SLNB) is noninferior to axillary staging in patients with early-stage breast cancer (BC) and negative axillary ultrasound (AxUS). We examined the generalizability of these findings in patients with hormone receptor (HR)+HER2- disease.

methodsPatients with cT1N0M0, HR+HER2- BC and negative AxUS undergoing breast conservation with SLNB from 2016 to 2023 were identified from a prospectively maintained database. Clinicopathologic characteristics, disease burden, adjuvant treatment, and oncologic outcomes were examined and compared with the SLNB arm of the SOUND trial. In postmenopausal patients, the impact of nodal status and 21-gene recurrence score on chemotherapy recommendations were also examined.

resultsOf 3972 patients with cT1N0M0 HR+HER2- breast cancer, 544 underwent AxUS; 312 met SOUND eligibility criteria. Median age was 57 (interquartile range [IQR] 48-64) years, and 199 (63.8%) were postmenopausal. Median (IQR) tumor size was 1.3 (0.9-1.7) cm, and 260 (83.3%) tumors were grade 1 or 2. Sentinel lymph node biopsy was positive in 38 (12.2%) patients. Only three (0.4%) had ≥ 4 positive lymph nodes. At a median follow-up of 26.2 (IQR 10.8-38.2) months, there were no axillary recurrences and one (0.3%) distant recurrence. Among postmenopausal women with recurrence score ≤ 25, chemotherapy recommendations were not associated with nodal status.

conclusionsExamination of our real-world HR+ HER2- "SOUND-eligible" population suggests that nodal disease burden and oncologic outcomes are similar to the SOUND trial population, supporting careful implementation of trial results into multidisciplinary practice. In postmenopausal patients, omission of SLNB does not appear to impact adjuvant chemotherapy recommendations.

Indexed as

Breast NeoplasmsErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenSentinel Lymph Node BiopsyAgedAxillaFemaleFollow-Up StudiesHumansMastectomy, SegmentalMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPostmenopausePrognosisProspective StudiesERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneAxillary ultrasoundHR+HER2 breast cancerSentinel lymph node biopsySOUND trial

Identifiers

PMID39402322

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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.