Evidence map›Paper›PMID 42582881›Full record

ReviewCureus2026

Axillary Nodal Involvement in Microinvasive Breast Cancer: A Systematic Review and Meta-Analysis of Sentinel Lymph Node Positivity and Disease Burden.

Hunter W Brady, Christiana Coonradt, Monica Roberts, Jasneet Gill, Gregory Keagy

Abstract readReview
In one paragraph

Review in Cureus, 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

5 authors.

Hunter W BradyMedicine, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, USA.
Christiana CoonradtMedicine, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, USA.
Monica RobertsMedicine, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, USA.
Jasneet GillInternal Medicine, Tennova North Knoxville Medical Center, Knoxville, USA.
Gregory KeagySurgery, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Microinvasive breast cancer represents a transitional entity between ductal carcinoma in situ and invasive disease, with generally favorable outcomes but an uncertain risk of lymph node involvement. The role of sentinel lymph node (SLN) biopsy in this population remains controversial. This study aimed to estimate the pooled rate of SLN positivity and characterize the burden of nodal metastasis in patients with microinvasive breast cancer. A systematic review and single-arm meta-analysis were conducted in accordance with PRISMA guidelines. PubMed was searched for studies published between 2015 and 2025 reporting SLN biopsy outcomes in patients with histologically confirmed microinvasive breast cancer (T1mi, ≤1 mm stromal invasion) undergoing sentinel lymph node biopsy. Eligible studies reported the number of patients undergoing biopsy and the number with positive nodes. Random-effects models were used to estimate pooled proportions of SLN positivity and metastatic burden, including isolated tumor cells (ITCs), micrometastases, and macrometastases. Seven studies comprising 11,243 patients were included. Overall, 500 patients (4.4%) were SLN-positive, with a pooled positivity rate of 8.6% (95% CI, 4.3-15.4%) and substantial heterogeneity (I² = 97%). Among SLN-positive cases, pooled proportions were 42.3% (95% CI, 29.2-56.5%) for ITCs, 41.4% (95% CI, 31.4-52.1%) for micrometastases, and 28.9% (95% CI, 15.5-47.5%) for macrometastases. SLN positivity in microinvasive breast cancer is uncommon but not negligible and is most often characterized by low-volume disease. Low-volume disease, including ITCs and micrometastases, comprised the majority of positive nodes, with macrometastases identified in a clinically meaningful subset. These findings support a selective, risk-adapted approach to axillary staging, balancing the potential diagnostic benefit of biopsy against procedural morbidity.

Indexed as

axillary de-escalationaxillary stagingmeta-analysismicroinvasive breast cancernodal me-tastasissentinel lymph node biopsysystematic reviewt1mi

Identifiers

PMID42582881
PMCPMC13459392

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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.