Evidence map›Paper›PMID 40748568›Full record

Observational studyBreast cancer (Tokyo, Japan)2025

A retrospective multi-center cohort study investigating safety of sentinel lymph node biopsy for axillary staging in clinical T3-4c breast cancer.

Sayaka Kuba, Yasuaki Sagara, Hiroshi Yano, Shigeto Maeda, Takehiko Sakai, Yasuyuki Kojima, Masaya Hattori, Sota Asaga, Eriko Tokunaga, Tadahiko Shien and 25 more

Abstract readMulticenter StudyObservational Study
PubMed 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 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. Review
  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

35 authors.

Sayaka KubaDepartment of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan. skuba@nagasaki-u.ac.jp.ORCID http://orcid.org/0000-0002-0225-099X
Yasuaki SagaraDepartment of Breast Surgical Oncology, Sagara Hospital, Kagoshima, Japan.
Hiroshi YanoClinical Research Center, Nagasaki University Hospital, Nagasaki, Japan.
Shigeto MaedaDepartment of Surgery, Nagasaki Rosai Hospital, Sasebo, Nagasaki, Japan.
Takehiko SakaiDepartment of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Yasuyuki KojimaDivision of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Masaya HattoriDepartment of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
Sota AsagaDepartment of Breast Surgery, Keiyu Hospital, Yokohama, Kanagawa, Japan.
Eriko TokunagaDepartment of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Tadahiko ShienDepartment of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Hiroko BandoBreast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Keisei AnanDepartment of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan.
Nobutaka IwakumaDepartment of Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Shigeki MinamiDepartment of Breast and Endocrine Surgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan.
Miki YamaguchiDepartment of Breast Surgery, JCHO Kurume General Hospital, Kurume, Fukuoka, Japan.
Michiko HaraoDepartment of Breast Oncology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Masahiro OikawaDepartment of Breast Surgery, Oikawa Hospital, Fukuoka, Japan.
Takafumi SangaiDepartment of Breast and Thyroid Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Makoto IshitobiDepartment of Breast Surgery, Osaka Habikino Medical Center, Osaka, Japan.
Takahiro NakayamaDepartment of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan.
Tetsu HayashidaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
Manami TadaDepartment of Breast Surgery, Kansai Medical University Hospital, Hirakata, Osaka, Japan.
Kentaro TamakiDepartment of Breast Surgery, Nahanishi Clinic, Naha, Okinawa, Japan.
Goro KutomiBreast Oncology, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Mai TomiguchiDepartment of Breast and Endocrine Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Narumi Harada-ShojiDepartment of Breast and Endocrine Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Kaname KurashitaDepartment of Breast Surgery, Urasoe General Hospital, Urasoe, Okinawa, Japan.
Kaori TerataDepartment of Breast and Endocrine Surgery, Akita University Hospital, Akita, Japan.
Kosho YamanouchiDepartment of Breast and Endocrine Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan.
Makoto KuboDepartment of Breast Surgical Oncology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan.
Chika YumuraDepartment of Breast Surgery Oncology, St Luke International Hospital, Tokyo, Japan.
Yoko TakahashiDepartment of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Shigeru ImotoDepartment of Breast Surgery, Faculty of Medicine, Kyorin University, Tokyo, Japan.
Shinji OhnoDepartment of Breast Surgical Oncology, Sagara Hospital, Kagoshima, Japan.
Naoki HayashiDivision of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSentinel lymph node biopsy (SLNB) has become a standard procedure for patients with breast cancer (BC) without clinically evident axillary metastasis. However, its role in cT3-4cN0 BC remains underexplored, leading to uncertainty regarding its safety.

methodsThis retrospective, multicenter observational study included patients with cT3-4cN0M0 BC who underwent radical surgery between 2006 and 2016. Patients were divided into an SLNB group, which included those who underwent SLNB exclusively and ALND after SLNB, and an ALND group, which included those who underwent ALND exclusively. Inverse probability treatment weighting was applied to balance the patient characteristics, with recurrence-free survival (RFS) as the primary endpoint.

resultsThe study included 930 patients: 716 in the SLNB group and 214 in the ALND group. The ALND group had a higher proportion of patients diagnosed earlier, more T4 tumors, and more frequent use of neoadjuvant chemotherapy. During a median follow-up period of 89 months, 176 RFS events and 51 loco-regional recurrence events occurred. After adjusting for confounding factors, no significant difference was found in 10-year RFS between the groups (74.2% vs. 79.2%). Adjusted hazard ratios for RFS did not differ between the groups, even when stratified by tumor stage (cT3, cT4) or neoadjuvant chemotherapy. No significant differences were observed between the SLNB and ALND groups in loco-regional recurrence rate (LRR), with 10-year LRR rates of 93.1% and 90.8%, respectively.

conclusionsSLNB was a safe axillary staging method for patients with cT3-4cN0M0 BC and does not impact RFS or LRR negatively when compared with ALND.

Indexed as

Breast NeoplasmsSentinel Lymph Node BiopsyAdultAgedAxillaFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph Node ExcisionLymph NodesMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingRetrospective StudiesAxillary lymph node dissectionBreast cancerLoco-regional recurrence rateRecurrence-free survivalSentinel lymph node biopsy

Identifiers

PMID40748568

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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.