Evidence map›Paper›PMID 40533639›Full record

ArticleAnnals of surgical oncology2025

Trends in Surgical Treatment for cT4 Breast Cancer After Neoadjuvant Systemic Therapy: A Nationwide Study in The Netherlands.

Britt A M Jansen, Johannes C Kelder, Tim Borchert, Dominique J P van Uden, Femke van der Leij, Carolien Schröder, Annemiek Doeksen, Sabine Siesling, Marissa C van Maaren, Emily L Postma

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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 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. 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

10 authors.

Britt A M JansenDepartment of Surgery, St. Antonius Hospital, Utrecht, The Netherlands. br.jansen@antoniusziekenhuis.nl.
Johannes C KelderDepartment of Statistical Analysis, St. Antonius Hospital, Nieuwegein, The Netherlands.
Tim BorchertDepartment of Surgery, St. Antonius Hospital, Utrecht, The Netherlands.
Dominique J P van UdenDepartment of Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Femke van der LeijDepartment of Radiation Oncology, University Medical Centre Utrecht, Cancer Centre, Utrecht, The Netherlands.
Carolien SchröderDepartment of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
Annemiek DoeksenDepartment of Surgery, St. Antonius Hospital, Utrecht, The Netherlands.
Sabine SieslingDepartment of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Marissa C van MaarenDepartment of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Emily L PostmaDepartment of Surgery, St. Antonius Hospital, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent guidelines recommend neoadjuvant systemic therapy (NST) followed by modified radical mastectomy (MRM) for stage T4 breast cancer. In this study, trends in MRM and de-escalated surgery of cT4a-c and cT4d breast cancer were evaluated and the impact of treatment on survival was assessed.

methodsPatients with cT4N

resultsThis study included 2,541 patients with cT4a-c and 1479 with cT4d breast cancer. The frequency of MRM decreased from 78% in 1989-1999 to 54% in 2010-2020 for cT4a-c and from 82% to 70% for cT4d patients. De-escalated surgery was associated with better overall survival than MRM, for both cT4a-c (HR 0.74, 95% confidence interval [CI] 0.63-0.87) and cT4d breast cancer (HR 0.78, 95% CI 0.63-0.96). Five-year crude relative survival for MRM versus de-escalated treatment was 66% (95% CI 0.64-0.69) versus 83% (95% CI 0.79-0.87) for cT4a-c, and 56% (95% CI 0.53-0.59) versus 70% (95% CI 0.64-0.76) for cT4d.

conclusionsModified radical mastectomy rates decreased over time. De-escalated surgery was associated with improved 5-year overall survival compared with MRM. These findings suggest that de-escalated surgery is at least equivalent to MRM in terms of survival and may support consideration of less invasive surgical approaches.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsMastectomy, Modified RadicalNeoadjuvant TherapyAdultAgedCombined Modality TherapyFemaleFollow-Up StudiesHumansMiddle AgedNeoplasm StagingNetherlandsPrognosisRegistriesSurvival RatecT4 breast cancerModified radical mastectomyNeoadjuvant systemic therapySurgical trendsSurvival

Identifiers

PMID40533639
PMCPMC12534241

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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.