{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:02:20Z","timestamp":1745640140115,"version":"3.40.4"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ir J Med Sci"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>CT thorax, abdomen and pelvis (CT-TAP) remains the standard in the identification of metastatic disease in patients with newly diagnosed breast cancer. In patients with proven micro and macro axillary nodal metastasis, the optimal radiological technique remains controversial. A consensus on which patients with axillary nodal disease should receive radiological staging for distant disease and how this should be performed is not currently available. The aim of this study was to evaluate the yield from CT staging of the thorax, abdomen and pelvis (CT-TAP) in patients with proven nodal disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients diagnosed with invasive breast cancer with a positive sentinel lymph node biopsy (SLNB) and subsequent staging CT-TAP between 2013 and 2017 were identified. Patient demographics, clinicopathological characteristics, CT-TAP findings and further imaging requirements were documented.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 234 patients were identified. Of these, 164 (70%) were found to have macrometastasis and 70 (30%) to have micrometastasis or isolated tumour cells on SLNB. Within the macrometastasis cohort, abnormalities were noted on staging CT-TAP for 100 (61%) patients. Eighty of the 100 received follow-up assessment of abnormalities with 3 (2%) patients being diagnosed with distant metastatic disease. Within the micrometastasis group, abnormalities on CT-TAP staging were noted in 36 (52.1%) patients. Twenty-eight (40%) patients required further investigation and follow-up. No patient was found to have metastatic disease within this group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Patients diagnosed with micrometastatic disease of the axilla following a sentinel lymph node biopsy do not require systemic staging as it fails to detect metastatic disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11845-025-03867-x","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T08:51:30Z","timestamp":1737363090000},"page":"447-452","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of systemic staging in breast cancer patients with a positive sentinel lymph node biopsy"],"prefix":"10.1007","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1229-4232","authenticated-orcid":false,"given":"Tim","family":"Harding","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick James","family":"O\u2019Donoghue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Boland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Evoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"McCartan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Rutherford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Prichard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"3867_CR1","unstructured":"Rashid OM, TK (2012) Sentinel lymph node biopsy for breast cancer: our technique and future directions in lymph node staging. J Nucl Med Radiat Ther 2012(S2)(005)"},{"issue":"8","key":"3867_CR2","doi-asserted-by":"publisher","first-page":"2182","DOI":"10.1245\/s10434-017-5866-7","volume":"24","author":"A Mamtani","year":"2017","unstructured":"Mamtani A, Patil S, Stempel M, Morrow M (2017) Axillary micrometastases and isolated tumor cells are not an indication for post-mastectomy radiotherapy in stage 1 and 2 breast cancer. Ann Surg Oncol 24(8):2182\u20132188","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"3867_CR3","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/S1470-2045(13)70035-4","volume":"14","author":"V Galimberti","year":"2013","unstructured":"Galimberti V, Cole B, Zurrida S and others (2013) Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23\u201301): a phase 3 randomised controlled trial. Lancet Oncol 14(4):297\u2013305","journal-title":"Lancet Oncol"},{"issue":"4","key":"3867_CR4","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/S0002-9610(01)00738-3","volume":"182","author":"W Liang","year":"2001","unstructured":"Liang W, Sickle-Santanello B, Nims T (2001) Is a completion axillary dissection indicated for micrometastases in the sintinel lymph node? Am J Surg 182(4):365\u2013368","journal-title":"Am J Surg"},{"issue":"6","key":"3867_CR5","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1038\/modpathol.3800394","volume":"18","author":"H Rutledge","year":"2005","unstructured":"Rutledge H, Davis J, Chiu R and others (2005) Sentinel node micrometastasis in breast carcinoma may not be an indication for complete axillary dissection. Mod Pathol 18(6):762\u2013768","journal-title":"Mod Pathol"},{"issue":"6","key":"3867_CR6","doi-asserted-by":"publisher","first-page":"691","DOI":"10.6004\/jnccn.2022.0030","volume":"20","author":"WJ Gradishar","year":"2022","unstructured":"Gradishar WJ, Moran MS, Abraham J and others (2022) Breast cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 20(6):691\u2013722","journal-title":"J Natl Compr Canc Netw"},{"key":"3867_CR7","unstructured":"Health Do (n.d.) Diagnosis, staging and treatment of patients with breast cancer. National clinical guideline No. 7. June 2015, with radiation oncology section retired May 2023. 2015"},{"key":"3867_CR8","doi-asserted-by":"publisher","unstructured":"Roszkowski N et al (2021) Expanded criteria for pretreatment staging CT in breast cancer. BJS Open 5(2). https:\/\/doi.org\/10.1093\/bjsopen\/zraa006","DOI":"10.1093\/bjsopen\/zraa006"},{"issue":"7","key":"3867_CR9","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1002\/bjs.10124","volume":"103","author":"DP McCartan","year":"2016","unstructured":"McCartan DP, Prichard RS, MacDermott RJ and others (2016) Role of bone scan in addition to CT in patients with breast cancer selected for systemic staging. Br J Surg 103(7):839\u201344","journal-title":"Br J Surg"},{"key":"3867_CR10","doi-asserted-by":"publisher","first-page":"5329","DOI":"10.2147\/CMAR.S176763","volume":"10","author":"W Xiao","year":"2018","unstructured":"Xiao W, Zheng S, Yang A and others (2018) Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study. Cancer Manag Res 10:5329\u20135338","journal-title":"Cancer Manag Res"},{"issue":"1","key":"3867_CR11","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1023\/A:1014900600815","volume":"72","author":"AEA Ravaioli","year":"2002","unstructured":"Ravaioli AEA (2002) Staging of breast cancer: new recommended standard procedure. Breast Cancer Res Treatment 72(1):53\u201360","journal-title":"Breast Cancer Res Treatment"},{"issue":"11","key":"3867_CR12","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1023\/A:1008483806113","volume":"9","author":"AEA Ravaioli","year":"1998","unstructured":"Ravaioli AEA (1998) Staging of breast cancer: what standards should be used in research and clinical practice. Annal Oncol 9(11):1173\u20131177","journal-title":"Annal Oncol"},{"issue":"2","key":"3867_CR13","doi-asserted-by":"publisher","first-page":"254","DOI":"10.2214\/AJR.19.21177","volume":"213","author":"U Ga","year":"2019","unstructured":"Ga U (2019) PET\/CT for patients with breast cancer: where is the clinical impact. AJR Am J Roentgenol 213(2):254\u2013265","journal-title":"AJR Am J Roentgenol"},{"issue":"5","key":"3867_CR14","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1080\/14737140.2022.2064277","volume":"22","author":"LM Pak","year":"2022","unstructured":"Pak LM, Morrow M (2022) Addressing the problem of overtreatment in breast cancer. Expert Rev Anticancer Ther 22(5):535\u2013548","journal-title":"Expert Rev Anticancer Ther"},{"key":"3867_CR15","unstructured":"J, BH (2024) Tumor, node, metastasis (TNM) staging classification for breast cancer. [cited 2024 01\/08\/2024]; Available from: https:\/\/www.uptodate.com\/contents\/tumor-node-metastasis-tnm-staging-classification-for-breast-cancer#references"},{"issue":"6","key":"3867_CR16","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1038\/bjc.2012.30","volume":"106","author":"G Lyratzopoulos","year":"2012","unstructured":"Lyratzopoulos G, Abel GA, Barbiere JM and others (2012) Greenberg DC, Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006\u20132009. Br J Cancer 106(6):1068\u201375","journal-title":"Br J Cancer"},{"issue":"8","key":"3867_CR17","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1001\/jama.2013.776","volume":"309","author":"RH Johnson","year":"2013","unstructured":"Johnson RH, Chien FL, Bleyer A (2013) Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA 309(8):800\u20135","journal-title":"JAMA"},{"issue":"2","key":"3867_CR18","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1007\/s10549-016-3687-1","volume":"155","author":"JM Brothers","year":"2016","unstructured":"Brothers JM, Kidwell KM, Brown RK, Henry NL (2016) Incidental radiologic findings at breast cancer diagnosis and likelihood of disease recurrence. Breast Cancer Res Treat 155(2):396\u2013403","journal-title":"Breast Cancer Res Treat"},{"issue":"6","key":"3867_CR19","doi-asserted-by":"publisher","first-page":"W602","DOI":"10.2214\/AJR.13.12337","volume":"202","author":"DK Powell","year":"2014","unstructured":"Powell DK (2014) Patient explanation guidelines for incidentalomas: helping patients not to fear the delayed surveillance. AJR Am J Roentgenol 202(6):W602\u2013W602","journal-title":"AJR Am J Roentgenol"},{"issue":"8","key":"3867_CR20","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1056\/NEJM198602203140809","volume":"314","author":"JW Mold","year":"1986","unstructured":"Mold JW, Stein HF (1986) The cascade effect in the clinical care of patients. New England J Med 314(8):512\u2013514","journal-title":"New England J Med"},{"issue":"9406","key":"3867_CR21","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/S0140-6736(04)15433-0","volume":"363","author":"AG de Berrington","year":"2004","unstructured":"de Berrington AG, Darby S (2004) Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 363(9406):345\u201351","journal-title":"Lancet"},{"issue":"7508","key":"3867_CR22","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1136\/bmj.38499.599861.E0","volume":"331","author":"E Cardis","year":"2005","unstructured":"Cardis E, Vrijheid M, Blettner M and others (2005) Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ 331(7508):77","journal-title":"BMJ"},{"key":"3867_CR23","doi-asserted-by":"publisher","first-page":"d1920","DOI":"10.1136\/bmj.d947","volume":"342","author":"HE Davies","year":"2011","unstructured":"Davies HE, Wathen C, Gleeson FV (2011) The risks of radiation exposure related to diagnostic imaging and how to minimise them. BMJ 342:d1920","journal-title":"BMJ"},{"key":"3867_CR24","unstructured":"O\u2019Connor C, Currivan L, Cunningham N et al (2014) Radiation doses recievd by the Irish population. Environ Protect Agency"},{"key":"3867_CR25","unstructured":"Margolese R, Hortobagyi GN, Buchholz TA (2003) Management of metastatic breast cancer, ed. P.R. In: Kufe DW, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition: Hamilton (ON): BC Decker; 2003. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK13196\/"},{"issue":"9","key":"3867_CR26","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1038\/sj.bjc.6605323","volume":"101","author":"T Barrett","year":"2009","unstructured":"Barrett T, Bowden D, Greenberg DC and others (2009) Radiological staging in breast cancer: which asymptomatic patients to image and how. Br J Cancer 101(9):1522\u20138","journal-title":"Br J Cancer"},{"issue":"6","key":"3867_CR27","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1308\/rcsann.2020.0065","volume":"102","author":"T Hubbard","year":"2020","unstructured":"Hubbard T, Ives C (2020) Significance of a positive sentinel lymph node biopsy in staging for distant metastasis in breast cancer: are current guidelines relevant. Ann R Coll Surg Engl 102(6):429\u2013436","journal-title":"Ann R Coll Surg Engl"},{"key":"3867_CR28","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.ijsu.2017.09.004","volume":"46","author":"J James","year":"2017","unstructured":"James J, Teo M, Ramachandran V and others (2017) Performance of CT scan of abdomen and pelvis in detecting asymptomatic synchronous metastasis in breast cancer. Int J Surg 46:164\u2013169","journal-title":"Int J Surg"},{"key":"3867_CR29","unstructured":"Radiologists TRCO (n.d.) Guidance on screening and symptomatic breast imaging, fourth edition. 2019: London: The Royal College of Radiologists"},{"issue":"6","key":"3867_CR30","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.1007\/s00268-015-2984-x","volume":"39","author":"M Co","year":"2015","unstructured":"Co M, Kwong A (2015) Macrometastasis, micrometastasis, and isolated tumor cells in sentinel lymph nodes of early breast cancers: a 10-year histopathological and survival analysis of 537 Asian patients. World J Surg 39(6):1438\u20131442","journal-title":"World J Surg"},{"issue":"2","key":"3867_CR31","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.surge.2016.07.002","volume":"15","author":"K Naidoo","year":"2017","unstructured":"Naidoo K, Pinder S (2017) Micro- and macro-metastasis in the axillary lymph node: a review. Surgeon 15(2):76\u201382","journal-title":"Surgeon"}],"container-title":["Irish Journal of Medical Science (1971 -)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11845-025-03867-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11845-025-03867-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11845-025-03867-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T06:14:13Z","timestamp":1745561653000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11845-025-03867-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,20]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["3867"],"URL":"https:\/\/doi.org\/10.1007\/s11845-025-03867-x","relation":{},"ISSN":["0021-1265","1863-4362"],"issn-type":[{"type":"print","value":"0021-1265"},{"type":"electronic","value":"1863-4362"}],"subject":[],"published":{"date-parts":[[2025,1,20]]},"assertion":[{"value":"12 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}