{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:46:20Z","timestamp":1793303180548,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T00:00:00Z","timestamp":1607212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Women with screen-detected invasive breast cancer who have macrometastatic disease on axillary sentinel lymph node biopsy (SLNB) are usually offered either surgical axillary node clearance (ANC) or axillary radiotherapy. These treatments can lead to significant complications for patients. The aim of this study was to identify a group of patients who may not require completion ANC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 2401 women included in the cohort, the presence of non-sentinel node disease was significantly affected by: the number of nodes obtained at SLNB (odds ratio (OR) 0.49 for retrieval of more than 1 node), invasive size of tumour (OR 1.63 for size greater than 20\u00a0mm), surgical treatment (OR 1.34 for mastectomy), human epidermal growth factor receptor (HER) 2 status (OR 0.71 for HER2 positivity), and patient age (OR 1.10 for age less than 50\u00a0years; OR 1.46 for age greater than 70\u00a0years). Patients aged less than 70\u00a0years, with tumour size smaller than 2\u00a0cm, more than one node retrieved on SLNB, and who had breast-conserving surgery had a lower chance of positive non-sentinel nodes on completion ANC compared with other patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study, of a purely screen-detected breast cancer cohort, identified a subset of patients who may be spared completion ANC in the event of a single axillary SLN with macrometastasis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraa022","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T10:49:11Z","timestamp":1615373351000},"source":"Crossref","is-referenced-by-count":4,"title":["Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6827-8090","authenticated-orcid":false,"given":"R V","family":"Dave","sequence":"first","affiliation":[{"name":"The Nightingale Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust , Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Cheung","sequence":"additional","affiliation":[{"name":"National Health Service Breast Screening Programme, Public Health England , Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Sibbering","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Foundation Trust , Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Kearins","sequence":"additional","affiliation":[{"name":"National Health Service Breast Screening Programme, Public Health England , Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Jenkins","sequence":"additional","affiliation":[{"name":"National Health Service Breast Screening Programme, Public Health England , Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Gandhi","sequence":"additional","affiliation":[{"name":"The Nightingale Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust , Manchester, UK"},{"name":"Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, University of Manchester , Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,6]]},"reference":[{"key":"2022071109172581800_zraa022-B1","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/S1470-2045(18)30380-2","article-title":"Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial","volume":"19","author":"Galimberti","year":"2018","journal-title":"Lancet Oncol"},{"key":"2022071109172581800_zraa022-B2","author":"National Institute for Health and Care Excellence"},{"key":"2022071109172581800_zraa022-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0167-8140(93)90037-9","article-title":"Radiotherapy alone in breast cancer. 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