Evidence map›Paper›PMID 41578263›Full record

ArticleBMC surgery2026

The effect of the number of negative lymph nodes removed during surgery on the survival and recurrence rates of patients with breast cancer after surgery.

Mansour Bahardoust, Ali Ranjbarpazuki, Fatemeh Naseri Rad, Negar Hashemi, Yasaman Tavakoli, Mohammad Kasra Rezaei, Meisam Haghmoradi, Mohammadsadra Shamohammadi, Adnan Tizmaghz

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 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

9 authors.

Mansour Bahardoust *Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali RanjbarpazukiSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Fatemeh Naseri RadSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Negar Hashemi *School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Yasaman TavakoliStudent Research Committee, Department of Medicine, Mazandaran University of Medical Science, Mazandaran, Sari, Iran.
Mohammad Kasra RezaeiDepartment of Biological Sciences, University of Toronto Scarborough, Toronto, ON, Canada.
Meisam HaghmoradiDepartment of Orthopedic Surgery, Urmia University of Medical Sciences, Urmia, Iran.
Mohammadsadra ShamohammadiGastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran. msadrashamohammadis@gmail.com.
Adnan TizmaghzBreast Cancer Research Center, Iran University of Medical Sciences, Tehran, Iran. adnan_ti@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAlthough numerous studies have assessed the prognostic value of negative lymph nodes (NLN) counts in breast cancer (BC), their findings on survival outcomes have been inconsistent. This study aimed to determine the impact of the number of NLNs removed on overall survival (OS) and recurrence-free survival (RFS) in patients with BC undergoing surgical treatment.

methodsIn this multicenter cohort study, we reviewed medical records of 1,384 patients with histologically confirmed BC who underwent a mastectomy from 2011 to 2022, retrospectively. Patients were stratified into three groups according to the number of NLNs removed: (1) < 10, (2) 10-20, and (3) > 20. The primary endpoints were 5-year OS and RFS. Survival was assessed by Kaplan-Meier analysis using log-rank tests to compare survival curves, and Cox proportional hazards models were used to identify prognostic factors.

resultsAt a mean follow-up of 54.6 months, the 5-year OS and RFS were estimated to be 65.5% and 54.2% respectively. Kaplan-Meier curves showed significantly improved survival in patients with ≥ 10 NLNs removed. Multivariate Cox regression demonstrated that the OS rate in patients with the number of NLNs removed > 20 was significantly better than in patients with the number of NLNs removed < 10 (HR: 0.69, 95% CI: 0.56, 0.86, P: 0.001). Also, the OS rate in patients with the number of NLNs removed between 10 and 20 was significantly better than in patients with the number of NLNs removed < 10 (HR: 0.85, 95% CI: 0.75, 0.96, P: 0.001). Additionally, age < 45, higher BMI, comorbidities, advanced tumor/nodal stage, high histologic grade, HER2 status, higher Ki-67, and higher lymph node ratio were independently associated with poorer OS and RFS.

conclusionThe removal of a greater number of tumor-free lymph nodes was independently associated with improved 5-year OS and RFS in BC patients following surgery.

Indexed as

Breast NeoplasmsLymph Node ExcisionLymph NodesMastectomyNeoplasm Recurrence, LocalAdultAgedFemaleHumansLymphatic MetastasisMiddle AgedPrognosisRetrospective StudiesSurvival RateBreast cancerNegative lymph nodesRecurrenceSurgerySurvival

Identifiers

PMID41578263
PMCPMC12911082

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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 Socratic graph.