Evidence map›Paper›PMID 39419889›Full record

ArticleAnnals of surgical oncology2025

Impact of Clipped Node as a Sentinel Lymph Node on Axillary Staging Following Neoadjuvant Chemotherapy in Clinically Node-Positive Breast Cancer.

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, 2025. 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
  2. Article
  3. 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

10 authors.

Alexandra M MooreDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abigail S CaudleDepartment 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.
Min YiDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Benjamin D SmithDepartment of Breast Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Vicente ValeroDepartment of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Wei YangDepartment of Breast Imaging, 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.
Kelly K HuntDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. khunt@mdanderson.org.
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

backgroundResidual disease after neoadjuvant chemotherapy (NAC) is prognostic and informs adjuvant treatment. Targeted axillary dissection (TAD) following NAC has low false-negative rates, facilitating accurate axillary staging. This study evaluates the clipped node status in axillary staging utilizing TAD.

methodsRetrospective review identified cN1 breast cancer patients treated with NAC and TAD from July 2013 to June 2023. Nodal ultrasound and biopsy defined cN1 status. Patient, tumor, and treatment characteristics were compared based on clipped node status (sentinel lymph node [SLN] or non-SLN). Multivariate analysis of factors associated with the clipped node as a non-SLN was performed.

resultsA total of 680 patients underwent TAD, 94.6% with dual-tracer mapping. In three patients (0.4%), no SLN was identified. The clipped node was a SLN in 610 patients (90%) and non-SLN in 70 (10.3%). When the clipped node was a non-SLN, 42 (60%) were positive for metastasis. In 22 of 42 patients (52%), the clipped non-SLN was the only positive node. The clipped non-SLN cohort had a higher proportion with >3 suspicious nodes at presentation (p = 0.003), fewer SLNs excised (mean 2.2 vs. 3.5, p ≤ 0.001), and fewer positive SLNs (p ≤ 0.001). On multivariate analysis, > 3 suspicious nodes on ultrasound (odds ratio 3.0, p = 0.001) and tumor size at presentation (odds ratio 0.9, p = 0.02) were significantly associated with the clipped node as a non-SLN.

conclusionsWhen the clipped node was a non-SLN, half of the time it was the only positive node and only residual disease on TAD. Given implications for adjuvant therapy, selective clipped node excision is recommended for precise identification of residual disease after NAC.

Indexed as

AxillaBreast NeoplasmsNeoadjuvant TherapyNeoplasm StagingSentinel Lymph NodeSentinel Lymph Node BiopsyAdultAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph Node ExcisionLymph NodesClipped nodeNeoadjuvant chemotherapyNode-positive breast cancerTargeted axillary dissection

Identifiers

PMID39419889
PMCPMC11675134

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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.