Evidence map›Paper›PMID 41848913›Full record

SynthesisBreast cancer research and treatment2026

Omission of axillary surgery in early breast cancer with negative lymph nodes: a systematic review and meta-analysis of randomized clinical trials.

Bárbara Bizzo Castelo, Luiz Gustavo Oliveira Brito, Renato Zocchio Torresan, Cássio Cardoso Filho, Giuliano Mendes Duarte

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2026. 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

5 authors.

Bárbara Bizzo CasteloState University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
Luiz Gustavo Oliveira BritoState University of Campinas (Unicamp), Campinas, São Paulo, Brazil. lgobrito@gmail.com.
Renato Zocchio TorresanState University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
Cássio Cardoso FilhoState University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
Giuliano Mendes DuarteState University of Campinas (Unicamp), Campinas, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate whether the omission of axillary surgery impacts clinical outcomes in patients with early-stage breast cancer and clinically negative lymph nodes.

methodsWe conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing no axillary surgery with standard axillary interventions (sentinel lymph node biopsy [SLNB] or axillary dissection [AD]). This study followed PRISMA guidelines and was registered in PROSPERO (CRD420250653779). Searches were conducted in PubMed, Web of Science, and Embase through June 2025. Outcomes assessed included overall survival (OS), disease-free survival (DFS), and axillary recurrence (AR). Meta-analyses were performed using RevMan 5.4. Risk of bias was assessed using the RoB 2 tool.

resultsOut of 853 records, seven RCTs including 8806 patients met the inclusion criteria. Among them, 2,915 patients underwent no axillary surgery, while 5891 received surgical axillary treatment. Two trials compared no surgery with SLNB, and five compared no surgery with AD. No significant differences were found in OS (OR = 1.02; 95% CI, 0.86-1.20; p = 0.84; I

conclusionThe omission of axillary surgery in early-stage breast cancer with clinically negative lymph nodes does not negatively impact overall or disease-free survival. However, it is associated with a higher-though still low-risk of axillary recurrence.

Indexed as

Breast NeoplasmsLymph Node ExcisionLymph NodesAxillaDisease-Free SurvivalFemaleHumansLymphatic MetastasisNeoplasm Recurrence, LocalNeoplasm StagingRandomized Controlled Trials as TopicSentinel Lymph Node BiopsyAxillary surgeryBreast cancerDisease-free survivalRandomized clinical trialsSentinel lymph node biopsy

Identifiers

PMID41848913
PMCPMC12999590

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.