Evidence map›Paper›PMID 40183891›Full record

ArticleAnnals of surgical oncology2025

Axillary Surgery After Neoadjuvant Chemotherapy for Breast Cancer: Population-Based Trends Over Time.

Ekaterina Kouzmina, Matthew Castelo, Nicole J Look Hong, Julie Hallet, Natalie Coburn, Frances C Wright, Lena Nguyen, Sonal Gandhi, Katarzyna J Jerzak, Andrea Eisen and 1 more

Abstract read
PubMed 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. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Ekaterina KouzminaDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Matthew CasteloDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Nicole J Look HongDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Julie HalletDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Natalie CoburnDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Frances C WrightDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Lena NguyenICES, Toronto, ON, Canada.
Sonal GandhiDepartment of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Katarzyna J JerzakDepartment of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Andrea EisenDepartment of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Amanda RobertsDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. amanda.roberts@sunnybrook.ca.

Funding

Canadian Cancer Society Canadian Cancer Society Challenge GrantOntario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC) Annual grantSunnybrook AFP Association Innovation Fund of the Alternative Funding Plan
6 · The paper itself

Abstract

backgroundSentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) is recommended for patients initially presenting with cN1 disease and evidence of clinical/imaging response after NAC. We aimed to describe real-world population changes in management.

methodsWe completed a population-based cohort study including adult women undergoing NAC followed by surgery for cT1-3N1 breast cancer between 1 April 2012 and 31 January 2020 in Ontario, Canada. Axillary surgeries (SLNB, axillary lymph node dissection [ALND], or SLNB followed by ALND) were studied over time using the Cochran-Armitage test, while multivariable logistic regression evaluated factors associated with surgery type.

resultsOverall, 2563 patients were analyzed (37.9% were HER2-positive [HER2+ve], 42.3% were hormone receptor-positive and HER2-ve [HR+/HER2-ve], and 19.8% were triple-negative [TN]). 593 (23.1%) patients underwent SLNB and 1860 (72.6%) underwent ALND, while 110 (4.3%) patients underwent SLNB + ALND. From 2012 to 2020, SLNB increased from 5.7 to 29.9% (p < 0.01) and SLNB + ALND increased from 1.7 to 4.7% (p < 0.01), while ALND decreased from 92.6 to 65.4% (p < 0.01). Similar trends were identified across all receptor groups. After adjustment, patients who underwent SLNB had fewer comorbidities (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.03-3.19), smaller tumors (T2 vs. T3: OR 1.52, 95% CI 1.21-1.92; T1 vs. T3: OR 1.56, 95% CI 1.14-2.13), and had surgery later in the study period (OR 1.32, 95% CI 1.25-1.38).

conclusionIn alignment with current practice guidelines, de-escalation of axillary surgery to SLNB has increased over time for patients after breast cancer NAC.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsLymph Node ExcisionNeoadjuvant TherapySentinel Lymph Node BiopsyAdultAgedAxillaChemotherapy, AdjuvantErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesHumansMiddle AgedOntarioPrognosisERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneAxillary lymph node dissectionBreast cancerHormonal statusNeoadjuvant chemotherapySentinel lymph node biopsy

Identifiers

PMID40183891

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.