Evidence map›Paper›PMID 42101740›Full record

ArticleAnnals of surgical oncology2026

Receipt of Combined Axillary Dissection and Nodal Irradiation Varies by Age.

Sara P Myers, Yevgeniya Gokun, Brandon Slover, Shley P Davenport, Herese Y Andraos, Nerea Lopetegui-Lia, Heather LeFebvre, Daniel G Stover, Elizabeth A Mittendorf, Tari A King and 1 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. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Sara P MyersDivision of Breast Surgery, Department of Surgery, The Ohio State University, Columbus, OH, USA. Sara.myers@osumc.edu.
Yevgeniya GokunCenter for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA.
Brandon SloverCenter for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA.
Shley P DavenportDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Herese Y AndraosDepartment of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Nerea Lopetegui-LiaDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Heather LeFebvreDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Daniel G StoverDivision of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Elizabeth A MittendorfDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Tari A KingDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Olga KantorDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCombination axillary lymph node dissection (ALND) and regional nodal irradiation (RNI) poses the greatest risk for breast cancer-related lymphedema. Despite interest in minimizing combination therapy (i.e., ALND+RNI) to avoid complications, concern remains over the oncologic safety of de-escalation in younger populations. This retrospective analysis explores the association between age and receipt of ALND+RNI to gain insight into patterns of axillary management.

methodsUsing the National Cancer Database (2018-2020), age-based differences in ALND+RNI among patients with stage I-III breast cancer undergoing surgery were examined. Patient and treatment characteristics were compared by age (<45, 45-64, and ≥65 years). Multivariable regression assessed associations between age and treatment, adjusting for clinical factors.

resultsAmong 439,790 patients, 7.5% were aged <45 years, 45.2% were 45-64, and 47.3% were ≥65. Patients aged <45 years (9.9%) were more commonly clinically node-positive (cN+) (vs 5.7% for age 45-64 and 5.5% for age ≥65 years; p<0.001). Younger patients were more likely to undergo ALND (23.8% vs 17.0% vs 16.3%), RNI (23.1% vs 16.9% vs 12.9%), and ALND+RNI (10.6% vs 6.2% vs 4.6%) (all p<0.001). On multivariable analysis, age <45 years had the highest odds of ALND+RNI (odds ratio 1.11; 95% confidence interval 1.03-1.20 vs ≥65 years) overall, but age did not impact ALND+RNI among those receiving neoadjuvant chemotherapy (p=0.209). On sensitivity analyses, those with cN+ molecular subtypes were more likely to receive ALND+RNI than those with clinical N0 disease.

conclusionWomen aged <45 years are more likely to receive ALND+RNI. These data highlight an opportunity for further studies targeting management in younger cohorts to limit overtreatment.

Indexed as

Breast NeoplasmsLymphatic IrradiationLymph Node ExcisionAdultAgedAge FactorsAxillaCombined Modality TherapyFemaleFollow-Up StudiesHumansLymph NodesMiddle AgedPrognosisRetrospective StudiesAgeAxillary lymph node dissectionBreast cancerBreast cancer-related lymphedemaRegional nodal irradiation

Identifiers

PMID42101740
PMCPMC13337919

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.