Evidence map›Paper›PMID 40377794›Full record

ArticleAnnals of surgical oncology2025

Predicting Outcomes of Breast-Conserving Surgery in Patients with Breast Cancer Using the Modified 5-Item Frailty Index: A Retrospective Cohort Study.

Samuel Knoedler, Jun Jiang, Philipp Moog, Julius M Wirtz, Thomas Schaschinger, Horacio Mayer, Hans-Guenther Machens, Sören Könneker, Gabriel Hundeshagen, Bong-Sung Kim and 2 more

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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 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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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

6 citing papers in PubMed.

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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

12 authors.

Samuel Knoedler *Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jun Jiang *Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Philipp MoogDepartment of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Julius M WirtzFaculty of Medicine, University of Freiburg, Freiburg, Germany.
Thomas SchaschingerMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Horacio MayerDepartment of Plastic Surgery, Hospital Italiano de Buenos Aires, University of Buenos Aires, Buenos Aires, Argentina.
Hans-Guenther MachensDepartment of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Sören KönnekerDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Gabriel HundeshagenDepartment of Hand-, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
Bong-Sung KimDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Dennis P OrgillDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Adriana C PanayiDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. adriana.panayi@icloud.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast cancer is the most common malignancy among women worldwide, with breast-conserving surgery (BCS) being a key treatment. The modified 5-item frailty index (mFI-5), a well-validated tool for assessing frailty, has shown predictive utility in other surgical contexts but remains under-explored in BCS. PATIENTS AND

methodsUsing the American College of Surgeons National Surgical Quality Improvement Program database (2008-2021), we identified adult female patients with breast cancer who underwent BCS. Frailty was assessed using the mFI-5 and scored from 0 to 5, with higher scores indicating greater frailty. Multivariable logistic regression was employed to evaluate associations between mFI-5 scores and postoperative outcomes.

resultsA total of 96,586 patients were included. Higher mFI-5 scores were significantly associated with older age, higher body mass index (BMI), and increased ASA scores. Multivariate analysis showed greater frailty was linked to higher risks of any (mFI = 1: OR 1.06; mFI = 2: OR 1.26; mFI ≥ 3: OR 2.45), surgical (mFI = 1: OR 1.18; mFI = 2: OR 1.65; mFI ≥ 3: OR 3.17), and medical complications (mFI = 1: OR 1.72; mFI = 2: OR 2.56; mFI ≥ 3: OR 6.05). Similarly, frail patients had significantly higher odds of mortality (mFI = 1: OR 2.27; mFI = 2: OR 4.3; mFI ≥ 3: OR 11.05) and unplanned readmission (mFI = 1: OR 1.38; mFI = 2: OR 2.25; mFI ≥ 3: OR 6.05). Reoperation risk decreased with higher mFI-5 scores (mFI = 1: OR 0.92; mFI = 2: OR 0.73; mFI ≥ 3: OR 0.92).

conclusionsThe mFI-5 is strongly associated with postoperative outcomes after BCS and serves as a valuable tool for risk stratification. Our findings reinforce its role as a critical preoperative index to identify high-risk patients and guide surgical planning.

Indexed as

Breast NeoplasmsFrailtyMastectomy, SegmentalPostoperative ComplicationsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMiddle AgedPrognosisRetrospective StudiesSurvival RateBreast-conserving surgeryFrailtymFI-5OutcomesQuality improvement

Identifiers

PMID40377794

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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.