Evidence map›Paper›PMID 40956528›Full record

ArticleAnnals of surgical oncology2025

Real-World Application of Alliance ACOSOG Z11102: How Many Patients Can be Spared Mastectomy?

Frances Phang, Brian Finkelman, Jessica Gooch, Ann Olzinski-Kunze, Kristin A Skinner, Daniel Kim, Kimberly Gergelis, Bradley Turner, Anna Weiss

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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

9 authors.

Frances Phang *Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Brian Finkelman *Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
Jessica GoochDepartment of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Ann Olzinski-KunzeDepartment of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Kristin A SkinnerDepartment of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Daniel KimDepartment of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Kimberly GergelisWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Bradley Turner *Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
Anna Weiss *Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Anna_weiss@urmc.rochester.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundACOSOG Z11102 demonstrated that breast-conserving surgery (BCS) with radiation is safe for multiple ipsilateral breast cancers (MIBCs), with re-excision and mastectomy conversion rates of 32.4% and 7.1%, respectively. Our objective was to evaluate the applicability of ACOSOG Z11102 in real-world practice.

methodsA retrospective review of MIBC patients was performed to collect clinical and demographic information. Pathology was re-reviewed by two breast pathologists assessing distance between foci and presence of significant pathology in intervening tissue (incidental invasive carcinoma, ductal carcinoma in situ [DCIS], atypical ductal hyperplasia [ADH], atypical lobular hyperplasia [ALH], lobular carcinoma in situ [LCIS], and flat epithelial atypia [FEA]).

resultsOverall, 116 evaluable patients (70 mastectomy, 46 BCS) were included. The median age was 64 years (range 34-93), the median number of foci was 2 (range 1-3), and the median size of the largest focus was 1.7 cm (range 0.4-6.5). Most patients were cT1 (84, 72.4%) and cN0 (111, 95.7%). Of the 46 BCS patients, 23 (50%) needed re-excisions. Eleven of these 23 (47.8%) patients had successful re-excisions, while 12 (52.2%) underwent mastectomy. The successful BCS rate was 73.9%, with conversion to mastectomy in 26.1%. On review of intervening tissue, 26 (22.4%) patients had no pathologic findings, 57 (49.1%) had DCIS, 19 (16.4%) had ALH, 13 (11.2%) had ADH, 11 (9.5%) had LCIS, 6 (5.2%) had additional incidental invasive carcinoma, and 1 (0.9%) had FEA. Factoring in intervening findings and Z11102 criteria, 15/70 (21.4%) patients who underwent mastectomy could have been eligible for BCS.

conclusionsPatient selection is critical when considering BCS for MIBC, as re-excision and mastectomy conversion rates may be higher in real-world practice.

Indexed as

Breast NeoplasmsMastectomy, SegmentalAdultAgedAged, 80 and overClinical Trials, Phase II as TopicFemaleHumansMastectomyMiddle AgedPatient SelectionRadiotherapy, AdjuvantReoperationRetrospective StudiesAtypiaBreast-conserving surgeryMastectomyMulticentric breast cancerMultifocal breast cancerMultiple ipsilateral breast cancer

Identifiers

PMID40956528

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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.