Evidence map›Paper›PMID 42135549›Full record

ArticleAnnals of surgical oncology2026

From Clinical Trial Awareness to Practice: Factors Associated with Intent to Omit Axillary Surgery Based on the SOUND Clinical Trial.

Ko Un Park, Megan Delisle, Michael J Hassett, Christina A Minami, Rinaa S Punglia, Samuel R Woodbury, Mary Brindle, Elizabeth A Mittendorf, Tari A King

Abstract readMulticenter Study
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 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. Review
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.

Ko Un ParkDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA. kpark16@bwh.harvard.edu.
Megan DelisleAriadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Michael J HassettBreast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Christina A MinamiDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.
Rinaa S PungliaBreast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Samuel R WoodburyAriadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Mary BrindleAriadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Elizabeth A MittendorfDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.
Tari A KingDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA.

Funding

Implementation of Operative Standards in Cancer Surgery to Improve Patient OutcomesK08CA263488 · NCI · OHIO STATE UNIVERSITY · PI Ko Un Park · 2022 to 2026
$1.3M
NCI NIH HHS K08 CA263488NCI NIH HHS K08CA263488
6 · The paper itself

Abstract

backgroundThe SOUND trial, published in 2023, demonstrated the oncologic safety of sentinel lymph node biopsy (SLNB) for select patients with early-stage breast cancer. We evaluated whether earlier awareness of the results of the SOUND trial was associated with increased intent to implement SLNB omission.

methodsThis multicenter, cross-sectional study surveyed North American physicians on current SLNB use, awareness of the SOUND trial results, and intent to implement trial findings. Intent was measured using the Innovation-Specific Implementation Intentions scale and scenario-based questions (ages 50 vs 60; whole- vs partial-breast irradiation), on a 5-point scale. The primary outcome was high intent to omit SLNB ("moderate" to "very great" extent). Multiple logistic regression identified factors associated with intent.

resultsThe response rate was 21% (208/1004): 148 (71.5%) surgeons, 32 (13.04%) medical and 27 (15.46%) radiation oncologists. Overall, 47.8% had already omitted SLNB in select patients aged < 70 years, and 63.6% reported high intent to use SOUND results. Among those who had not yet omitted SLNB (n = 108), 59.3% had high intent. Length of awareness of the SOUND trial (odds ratio 1.13) and practicing in Northeast USA vs Western USA (odds ratio 3.45, p = 0.032) were associated with increased intent to omit SLNB. In scenario-based questions, most endorsed omission for a 60-year-old patient receiving whole-breast irradiation (n = 105 [50.5%]); willingness decreased for a 50 year old or when partial-breast irradiation was planned. Across scenarios, intent was not associated with SOUND awareness duration, clinician characteristics, or referral workflows.

conclusionsEarlier awareness of the SOUND trial and regional differences were associated with greater intent to omit SLNB.

Indexed as

AwarenessBreast NeoplasmsClinical Trials as TopicHealth Knowledge, Attitudes, PracticeIntentionLymph Node ExcisionPractice Patterns, Physicians'Sentinel Lymph Node BiopsyAgedAxillaCross-Sectional StudiesFemaleFollow-Up StudiesHumansMiddle AgedPrognosisAxillary surgeryBreast cancerDe-implementationSentinel lymph node biopsyTreatment de-escalation

Identifiers

PMID42135549
PMCPMC13452869

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.