Evidence map›Paper›PMID 41817936›Full record

ArticleAnnals of surgical oncology2026

Axillary Nodal Positivity in Early-Stage Invasive Lobular Carcinoma: Implications for Sentinel Lymph Node Biopsy Omission.

Lorenzo Scardina, Sabatino D'Archi, Cristina Accetta, Beatrice Carnassale, Alba Di Leone, Flavia De Lauretis, Antonio Franco, Federica Gagliardi, Stefano Magno, Francesca Moschella and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article 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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

20 authors.

Lorenzo ScardinaBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. lorenzo.scardina@policlinicogemelli.it.ORCID http://orcid.org/0000-0002-5828-2851
Sabatino D'ArchiBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Cristina AccettaBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Beatrice CarnassaleBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Alba Di LeoneBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Flavia De LauretisBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Antonio FrancoBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Federica GagliardiBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Stefano MagnoBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Francesca MoschellaBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Maria NataleBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Alejandro Martin SanchezBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Marta SilenziBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Ersilia BiondiBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Enrico Di GuglielmoBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Elisabetta GambaroBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Annasilvia Di PumpoBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Eleonora PetrazzuoloBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Chiara RiannaBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Gianluca FranceschiniBreast Unit, Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent trials suggest omission of sentinel lymph node biopsy (SLNB) for selected early-stage breast cancer patients. However, invasive lobular carcinoma (ILC) is underrepresented, and retrospective data indicate higher rates of nodal metastases, raising concerns about axillary understaging. This study aimed to evaluate the prevalence and predictors of nodal metastases in early-stage, clinically node-negative ILC.

methodsThis study retrospectively analyzed 491 patients with estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, clinical T1, clinically node-negative ILC who underwent breast-conserving surgery at our institution between 2004 and 2024. The exclusion criteria ruled out neoadjuvant therapy, tumor larger than 2 cm, and metastatic disease at diagnosis or prior breast cancer.

resultsAmong 491 patients, 392 (79.8 %) were pN0, whereas 99 (20.2 %) had nodal metastases (pN1mi-pN3). Pathologic tumor size was significantly associated with axillary nodal involvement (p = 0.004). In contrast, histologic subtype was not significantly associated with nodal status (p = 0.15), although pleomorphic tumors demonstrated numerically higher rates of nodal involvement than classic invasive lobular carcinoma. Menopausal status was not predictive of nodal positivity (p = 0.96).

conclusionsApproximately one (20.2 %) in five patients with early-stage, clinically node-negative ILC harbors occult axillary nodal metastases. Pathologic tumor size emerged as the primary determinant of nodal involvement. Pleomorphic variants showed a tendency toward higher nodal burden. These findings indicate that omission of SLNB in ILC may carry a risk of axillary understaging with potential therapeutic implications. Pending evidence from prospective studies specifically designed for lobular histology, SLNB should continue to be considered an essential component of axillary evaluation in this subgroup.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularLymph NodesSentinel Lymph Node BiopsyAdultAgedAged, 80 and overAxillaErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesHumansLymphatic MetastasisMastectomy, SegmentalMiddle AgedErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenAxillary stagingDe-escalation therapyEarly-stage breast cancerInvasive lobular carcinomaSentinel lymph node biopsy

Identifiers

PMID41817936
PMCPMC13179177

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.