Evidence map›Paper›PMID 40413693›Full record

Observational studyBreast cancer (Tokyo, Japan)2025

Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.

Shigeru Imoto, Hiroyuki Yasojima, Takeshi Nagashima, Tatsuya Onishi, Tsutomu Takashima, Masahiro Kitada, Masaya Kawada, Tetsu Hayashida, Yasuto Naoi, Tomohiko Aihara and 10 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Breast cancer (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

20 authors.

Shigeru ImotoDepartment of Breast Surgery, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. imoto@ks.kyorin-u.ac.jp.ORCID http://orcid.org/0000-0002-0878-7851
Hiroyuki YasojimaNHO Osaka National Hospital, Osaka, Japan.
Takeshi NagashimaChiba University Hospital, Chiba, Japan.
Tatsuya OnishiNational Cancer Center Hospital East, Kashiwa, Japan.
Tsutomu TakashimaNara Prefecture Seiwa Medical Center, Ikoma, Japan.
Masahiro KitadaAsahikawa Medical University Hospital, Asahikawa, Japan.
Masaya KawadaTonan Hospital, Sapporo, Japan.
Tetsu HayashidaKeio University School of Medicine, Tokyo, Japan.
Yasuto NaoiKyoto Prefectural University of Medicine, Kyoto, Japan.
Tomohiko AiharaAihara Hospital, Minoh, Japan.
Noriaki WadaTokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Hidetaka KawabataToranomon Hospital, Tokyo, Japan.
Masayuki YoshidaSeirei Social Welfare Community, Seirei Center for Health Promotion and Preventive Medicine, Hamamatsu, Japan.
Uhi TohKurume University Hospital, Kurume, Japan.
Kimiyasu YoneyamaHiratsuka City Hospital, Hiratsuka, Japan.
Akimitsu YamadaYokohama City University Hospital, Yokohama, Japan.
Hitoshi TsudaChiba Medical Center, Chiba, Japan.
Norikazu MasudaGraduate School of Medicine, Kyoto University, Kyoto, Japan.
Mari Saito-ObaNational Center of Neurology and Psychiatry, Kodaira, Japan.
Junichi SakamotoTokai Central Hospital, Kakamigahara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN). PATIENTS AND

methodsFemale patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups.

resultsOf the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively.

conclusionsALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.

Indexed as

Breast NeoplasmsLymph Node ExcisionSentinel Lymph NodeSentinel Lymph Node BiopsyAdultAgedAged, 80 and overAxillaFemaleFollow-Up StudiesHumansLymphatic MetastasisMastectomyMastectomy, SegmentalMiddle AgedNeoplasm MicrometastasisBreast cancerRegional nodal irradiationRegional node recurrenceSentinel node biopsy

Identifiers

PMID40413693
PMCPMC12394296

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.