Evidence map›Paper›PMID 42436334›Full record

ArticleAnnals of surgical oncology2026

Variation in Surgical Management of Stage IV Breast Cancer: Local/Institutional and Regional Geographic Considerations.

Shruti Zaveri, Zachary A Whitham, Anvy Nguyen, Arushii Nadar, A Marilyn Leitch, Glenda Delgado, Deborah Farr, Rachel Wooldridge, Anthony Froix, Stephanie K Serres

Abstract read
PubMed Full text at PMC Publisher
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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. 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

10 authors.

Shruti ZaveriDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Zachary A WhithamDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Anvy NguyenDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Arushii NadarDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
A Marilyn LeitchDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Glenda DelgadoDivision of Hematology/Oncology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Deborah FarrDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Rachel WooldridgeDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Anthony FroixDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Stephanie K SerresDivision of Surgical Oncology, Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA. Stephanie.Serres@utsouthwestern.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrior studies have demonstrated variation in surgical management of breast cancer. As randomized controlled trials have increasingly shown a limited survival advantage with surgery in stage IV breast cancer, the present study aimed to assess geographic and institutional variations in locoregional surgical management of de novo stage IV breast cancer.

methodsWe conducted a retrospective cohort analysis of 68,670 patients with de novo stage IV breast cancer from 2012 to 2021 using the National Cancer Database. The proportion of patients treated with surgical resection was compared between year of diagnosis, facility type, geographic region, and facility volume while controlling for demographic and clinical variables.

resultsOverall, 17,620 patients (25.7%) with de novo stage IV breast cancer underwent breast, axillary, or metastatic site surgical resection. There was a statistically significant decrease from 27.4 to 15.0% in the proportion of patients undergoing primary tumor resection over the included timeframe (p < 0.001). Significant variation was noted in the proportion of patients receiving primary tumor resection among geographic regions, ranging from 14.9 to 23.2% (Northeast and West, p < 0.001). Patients treated at comprehensive community cancer centers were most likely to have primary site surgery, and those treated at academic centers (including National Cancer Institute-designated comprehensive cancer centers) were least likely (22.1 vs. 16.7%, respectively, p < 0.001).

conclusionSignificant variation exists in locoregional surgical management of de novo stage IV breast cancer. Surgical intervention has decreased over time, but this study reveals that institutional and geographic factors are associated with the surgical management for these patients.

Indexed as

Breast NeoplasmsCancer Care FacilitiesMastectomyAgedFemaleFollow-Up StudiesHumansMiddle AgedNeoplasm StagingPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID42436334
PMCPMC13586017

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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.