Evidence map›Paper›PMID 40205150›Full record

ArticleAnnals of surgical oncology2025

Utility of Surgical Axillary Staging in Microinvasive Ductal Carcinoma In Situ: A National Cancer Database Analysis.

Christian X Lava, Varsha Harish, Kelly Kapp, Karen R Li, Austin D Williams, Nathan Wong, Sami Ferdousian, Carmen De Carvajal, Ashwini Paranjpe, Ian T Greenwalt and 3 more

Abstract read
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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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Complete disappearance of ductal carcinomaAnnals of medicine and surgery (2012) · 2026
    Article
  2. 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

13 authors.

Christian X LavaGeorgetown University School of Medicine, Washington, DC, USA.
Varsha HarishGeorgetown University School of Medicine, Washington, DC, USA.
Kelly KappDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Karen R LiGeorgetown University School of Medicine, Washington, DC, USA.
Austin D WilliamsDepartment of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
Nathan WongDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Sami FerdousianGeorgetown University School of Medicine, Washington, DC, USA.
Carmen De CarvajalDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Ashwini ParanjpeDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Ian T GreenwaltDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Jennifer D SonDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA.
Kenneth L FanDepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
Lucy M De La CruzDivision of Breast Surgery, Department of Surgery, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, Washington, DC, USA. lucy.delacruz@medstar.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical axillary staging (ASx) of patients with microinvasive ductal carcinoma in situ (cT1mi) is debated due to the low occurrence of nodal metastasis. This study aimed to assess the utility of surgical axillary staging for clinically node-negative (cN0) T1mi breast cancer patients.

methodsThis retrospective cohort study analyzed data from the National Cancer Database (NCDB) to investigate the axillary status of patients with cT1mi breast cancer between 2012 and 2019. Patient demographics, clinical characteristics, treatment methods, and pathologic findings were collected.

resultsOf 10,843 patients, 9220 (85%) underwent ASx, whereas 1623 (15%) did not. Of the 4190 patients who underwent mastectomy, 244 (6%) did not undergo ASx, whereas 3946 (94%) did, 373 (9%) of whom were pN+. Of the 9069 patients who underwent ASx and had known nodal status, 8512 (94%) were pN- and 557 (6%) were pN+. The factors independently associated with increased odds of having positive nodes were younger age (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.01-1.03; p < 0.001), black race (OR, 1.51; 95% CI, 1.12-2.10; p = 0.007), lymphovascular invasion (OR, 13.72; 95% CI, 10.25-18.36; p < 0.001), and mastectomy (OR, 1.98; 95% CI, 1.57-2.51; p < 0.001). Among the pN+ patients, only 64 (1%) had ≥3 positive nodes and would require axillary lymph node dissection (ALND).

conclusionSurgical axillary staging is commonly performed for patients with cT1mi breast cancer despite the pN- status of most and the disproportionate morbidity associated with ASx. Identifying factors that predict a higher likelihood of pN+ status could allow for personalized surgical approaches, reducing unnecessary ASx for many patients.

Indexed as

Breast NeoplasmsCarcinoma, Intraductal, NoninfiltratingLymph Node ExcisionLymph NodesAdultAgedAxillaDatabases, FactualFemaleFollow-Up StudiesHumansLymphatic MetastasisMastectomyMiddle AgedNeoplasm InvasivenessNeoplasm StagingAxillary lymph node dissectionBreast neoplasmsDuctal carcinoma in situMicroinvasive breast carcinomaNational cancer database;Sentinel lymph node biopsy

Identifiers

PMID40205150

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.