{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:30:06Z","timestamp":1792445406305,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Understanding the factors influencing nodal status in breast cancer is vital for axillary staging, therapy, and patient survival. The nodal stage remains a crucial factor in prognostication indices. This study investigates the relationship between tumour-to-skin distance (in T1\u2013T3 tumours where the skin is not clinically involved) and the risk of nodal metastasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively reviewed data from 100 patients who underwent neoadjuvant chemotherapy (NACT). Besides patient demographics and tumour variables, a radiologist retrospectively reviewed pre-operative MRI to measure tumour-to-skin distance. R core packages were used for univariate (\u03c72 and T-Wilcoxon tests) and bivariate logistic regression statistical analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 95 analysable datasets, patients\u2019 median age was 51\u00a0years (IQR: 42\u201361), 97% were symptomatic (rest screen detected), and the median tumour size was 43\u00a0mm (IQR, 26\u201352). On multivariate analysis, increasing invasive tumour size (<jats:italic>p<\/jats:italic> = 0.02), ER positivity (<jats:italic>p<\/jats:italic> = 0.007)\u00a0and shorter tumour-to-skin distance (<jats:italic>p<\/jats:italic> = 0.05) correlated with nodal metastasis.\u00a0\u00a0HER2\u00a0was not included in multivariate analysis as there was\u00a0no association with nodal status on univariate analysis. In node-positive tumours, as tumour size increased, the tumour-to-skin distance decreased (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212\u00a00.34, <jats:italic>p<\/jats:italic>\u2009=\u20090.026). In node-negative tumours, there was no correlation (<jats:italic>r<\/jats:italic>\u2009=\u2009+\u20090.18, <jats:italic>p<\/jats:italic>\u2009=\u20090.23).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study shows that non-locally advanced cancers closer to the skin (and consequent proximity to subdermal lymphatics) are associated with a greater risk of nodal metastasis. Pre-operative identification of those more likely to be node positive may suggest the need for a second-look USS since a higher nodal stage may lead to a change in therapeutic strategies, such as upfront systemic therapy, node marking, and axillary clearance without the need to return to theatre following sentinel node biopsy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-023-07230-5","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T05:19:31Z","timestamp":1706937571000},"page":"109-116","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigating the role of tumour-to-skin proximity in predicting nodal metastasis in breast cancer"],"prefix":"10.1007","volume":"205","author":[{"given":"Thiviya","family":"Sivakanthan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Tanner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Mahata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3144-0493","authenticated-orcid":false,"given":"A.","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,3]]},"reference":[{"key":"7230_CR1","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1245\/s10434-018-6486-6","volume":"25","author":"AE Giuliano","year":"2018","unstructured":"Giuliano AE, Edge SB, Hortobagyi GN (2018) Eighth edition of the AJCC cancer staging manual: breast cancer. 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