ArticleAnnals of surgical oncology2025
Downstream Effects of Omission of Axillary Surgery in Older Adults with Early-Stage HR+/HER2- Breast Cancer.
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 4 papers.
What it found
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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.
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.
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Who cites it
4 citing papers in PubMed.
- Economic and Health System Impact of Implementing the SOUND Trial Approach in Early-Stage Breast Cancer.Annals of surgical oncology · 2026Article
- De-Escalation of Axillary Surgery: A Review of Choosing Wisely Guideline Evidence.World journal of oncology · 2026Review
- Contemporary Nodal Management and Overall Survival of Older Patients with HR-/HER2+ Breast Cancer.Annals of surgical oncology · 2026Article
- Evaluating the role of sentinel lymph node biopsy in cT1-2N0M0 breast cancer: a SEER-based study.Gland surgery · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTrial data demonstrate that omission of select locoregional therapies in women ≥ 70 years with early-stage HR+/HER2- breast cancer does not affect overall survival. However, the potential downstream effects of omitting sentinel lymph node biopsy (SLNB) on rates of adjuvant radiotherapy (RT) and endocrine therapy (ET) are unclear. We examined the association between SLNB omission, RT referral rates, RT receipt, and ET adherence in this population.
methodsPatients ≥ 70 years with unifocal cT1-2N0 HR+/HER2- disease undergoing upfront lumpectomy from January 2016 to January 2021 were identified from an institutional database. Radiotherapy referral, receipt, and ET adherence were examined by SLNB receipt. Multivariate logistic regression adjusting for patient and disease-level characteristics was used to assess factors associated with RT receipt and ET adherence.
resultsOf 670 patients, 460 (68.7%) had SLNB omitted. Only 19 (9.0%) who underwent SLNB were node-positive. Radiotherapy referrals were made for 68.5% of patients. More patients who underwent SLNB received RT referral (90.5%), treatment (77.4%), and were ET-adherent (77.6%) (p < 0.001). On adjusted analyses, patients ≥ 80 years and those with SLNB omitted were less likely to receive RT and be ET adherent. There was no difference in ipsilateral breast recurrence by SLNB performance (2.6% [SLNB] vs. 2.4% [no-SLNB], p = 0.86), or by RT receipt (2.7% [RT] vs. 2.4% [no-RT], p = 0.77) at a median 3.6 years.
conclusionsOmission of SLNB is associated with a lower likelihood of subsequent RT referral, receipt, and ET adherence. Locoregional rates did not differ by SLNB or RT receipt, suggesting that global de-escalation of locoregional therapies may be considered in older candidates.
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