SynthesisAnnals of surgical oncology2026
A Systematic Review of Occult Malignancy and Sentinel Lymph Node Metastasis at the Time of Contralateral Prophylactic Mastectomy.
Synthesis in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Is Mastectomy Necessary in Patients with Occult Breast Cancer and Advanced (N2/N3) Nodal Disease?Annals of surgical oncology · 2026Observational
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOccult malignancy (OM) identified in contralateral prophylactic mastectomy (CPM) presents a challenge for axillary management.
methodsThis meta-analysis identified retrospective studies using PubMed, Embase, and Cochrane Reviews with the keywords OM and CPM. In this study, OM was defined as invasive disease only. To determine the proportion of OM and node positivity rates, MedCalc software was used.
resultsThe 27 studies in this meta-analysis included 5728 patients who underwent CPM, with OM identified in 87 patients. The pooled incidence of OM was 1.55%. Of the 73 patients with axillary staging details available, 41 patients with OM (56%) underwent surgical axillary staging. Of these 41 patients, 8 had a positive sentinel lymph node (SLN) (20%), and 4 of the 8 patients had subsequent axillary lymph node dissection (ALND) with no additional positive lymph nodes identified. For 64 of the 87 patients with OM, T category was available. Of these 64 patients, 62 (97%) had pT1 and 2 (3%) had pT2 carcinoma. Histologic subtype was available for 52 OMs. Of these, 39 (75%) were ductal, 8 (15%) were lobular, and 5 (10%) were other. Biomarkers were available for 33 OMs, of which 21 (64%) were luminal A, 3 (9%) were luminal B, 3 (9%) were luminal human epidermal growth factor receptor 2 (HER2), and 6 (18%) were triple-negative.
conclusionsOccult malignancy in CPM is uncommon (1.55%), and when it occurs, it is predominantly pT1, luminal A, or invasive ductal carcinoma. Occult malignancy with SLN metastasis occurs in only 0.1% of CPMs, and when present, SLN metastasis is low volume (≤2 nodes). This supports the current guideline recommendations against routine SLN surgery at the time of CPM.
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Registered trials
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