Evidence map›Paper›PMID 42365710›Full record

Observational studyBreast (Edinburgh, Scotland)2026

What are the determinants of type of breast surgery following neoadjuvant chemotherapy? An analysis of breast cancer patients among Italian SENONET centers: NEOIMPACT study.

A De Luca, M I Amabile, M Tomatis, A Ponti, L Marotti, M Calabrese, C Marchiò, F Puglisi, I Palumbo, C Tinterri and 3 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Breast (Edinburgh, Scotland), 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

13 authors.

A De LucaDepartment of Surgery, Sapienza University of Rome, Rome, Italy.
M I AmabileDepartment of Surgery, Sapienza University of Rome, Rome, Italy. Electronic address: mariaida.amabile@uniroma1.it.
M TomatisAPS Senonetwork Italia, Florence, Italy.
A PontiCPO Piemonte, Turin, Italy; Eusoma, Florence, Italy.
L MarottiEusoma, Florence, Italy.
M CalabreseDepartment of Radiology, IRCCS-Ospedale Policlinico San Martino, Genoa, Italy.
C MarchiòDepartment of Medical Sciences, University of Turin, Turin, Italy; Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
F PuglisiDepartment of Medical Oncology, National Cancer Institute, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, PN, Italy.
I PalumboRadiation Oncology Unit, Perugia General Hospital, Perugia, Italy; Department of Civil and Environmental Engineering, University of Perugia, Perugia, Italy.
C TinterriDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy; Breast Unit, Humanitas Research Hospital, Rozzano, MI, Italy.
M TaffurelliAPS Senonetwork Italia, Florence, Italy; Alma Mater Studiorum, University of Bologna, Bologna, Italy.
L FortunatoBreast Center, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy.
Senonet Collaborative Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConcerns remain regarding determinants of breast-conserving surgery (BCS) following NACT, particularly in presence of a pathologic complete response (pCR).

methodsRetrospective analysis of 65,926 women treated at 26 Italian Breast Centers between 2017 and 2022 using the data-warehouse, SENONET. Clinical and pathological data of patients treated with NACT were analyzed to identify factors influencing surgical decision-making.

resultsA total of 4366 BC patients received NACT, of whom 2008 women (46%) underwent BCS. A non-significant trend over time in the adoption of BCS was observed (p = 0.187). Lower rates of BCS were significantly associated with age ≤49 years, multifocal/multicentric disease, microcalcifications, presence of DCIS, tumor ≥2 cm or cN+ (p < 0.05). A pCR was achieved in 31% of patients but was not associated with higher BCS rates (p = 0.353). Among patients achieving a pCR with either unifocal or multicentric tumor, 283/783 (36%) and 104/117 (89%) women underwent mastectomy, respectively. After mastectomy, 1749/2358 patients (74%) received breast reconstruction, with an increase over time for both an immediate breast reconstruction (IBR) and a nipple-sparing mastectomy approach (p = 0.012). Age <50 years and pCR were significantly associated with IBR (p < 0.001) while cT2+ stage (p = 0.028), cN+ (p < 0.001), and age >70 years (p < 0.001) resulted negatively associated with IBR.

conclusionsBCS remains underutilized after NACT, and surgical choices continue to be predominantly guided by pre-treatment clinical features rather than tumor response. Even among patients with biologically responsive unicentric tumors and those achieving pCR a significant propensity for mastectomy persists. These findings highlight the urgent need for updated guidelines to reduce unnecessary mastectomies.

Indexed as

Breast NeoplasmsMastectomyMastectomy, SegmentalNeoadjuvant TherapyAdultAgedChemotherapy, AdjuvantFemaleHumansItalyMiddle AgedPathologic Complete ResponseRetrospective StudiesBreast cancerBreast conservation surgeryBreast unitDe-escalation surgeryMastectomyNeoadjuvant chemotherapy

Identifiers

PMID42365710
PMCPMC13330659

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.