# Final Word Count Audit

**Manuscript:** Axillary Management After NAC in cN+ Breast Cancer: Umbrella Review of 23 SRs/MAs (2006-2026)
**Date:** 2026-05-14
**After editorial pass edits E1-E10**

---

## 1. Total word count (manuscript.md)

| Component | Words |
|---|---|
| Header (title, authors, affiliations, word-count footer) | 63 |
| Abstract (in-manuscript copy) | 129 |
| § 1 Introduction | 624 |
| § 2 Methods (sum of subsections, including 2.1-2.9) | **1,683** |
| § 3 Results (sum of subsections, including 3.1-3.10) | **2,206** |
| § 4 Discussion (sum of subsections, including 4.1-4.7) | **1,170** |
| § 5 Conclusions + back-matter (Funding, COI, Data, Author contrib, Acknowledgements, footer note about excluded SRs) | 462 |
| Section-header tokens (e.g. "## 2. Methods", "### 2.1 Protocol and reporting") — counted within their parent | (included above) |
| **TOTAL (manuscript.md raw word count)** | **6,336** |

**Manuscript text excluding abstract, references, headers, back-matter:** approximately **5,700 words** (Introduction + Methods + Results + Discussion + Conclusion = 624 + 1,683 + 2,206 + 1,170 + ~190 conclusion-narrative-only = 5,873; minus headers ≈ 5,700-5,800).

---

## 2. Per-section word count (full breakdown)

| Section | Words | % of body | Action |
|---|---|---|---|
| § 1 Introduction | 624 | 11.0% | OK |
| § 2.1 Protocol and reporting | 108 | 1.9% | OK |
| § 2.2 Eligibility criteria | 339 | 6.0% | Long but justified (PICOS + post-hoc PICOS triage rationale + 10-SR exclusion list) |
| § 2.3 Information sources and search strategy | 153 | 2.7% | OK |
| § 2.4 Selection process | 114 | 2.0% | OK |
| § 2.5 Data extraction | 101 | 1.8% | OK |
| § 2.6 Methodological-quality assessment | **405** | 7.1% | **TIGHTEN** — long single paragraph, AMSTAR-2 narrative could be split or trimmed by ~100 words |
| § 2.7 Certainty of evidence (GRADE) | 290 | 5.1% | Acceptable |
| § 2.8 Synthesis | 133 | 2.3% | OK |
| § 2.9 Patient and public involvement | 30 | 0.5% | OK (renumbered from §2.8) |
| § 3.1 Search and selection | 142 | 2.5% | OK |
| § 3.2 Characteristics of the included reviews | 239 | 4.2% | OK |
| § 3.3 Methodological quality (AMSTAR-2) | **614** | 10.8% | **TIGHTEN** — 4-paragraph block, candidate for collapsing to 2 paragraphs (~400 words). Highest-priority cut. |
| § 3.4 Nodal pCR rates by molecular subtype | 206 | 3.6% | OK |
| § 3.5 False-negative rate of axillary techniques | 238 | 4.2% | OK |
| § 3.6 Long-term oncological outcomes | 150 | 2.7% | OK |
| § 3.7 Isolated tumour cells (ypN0[i+]) | 131 | 2.3% | OK |
| § 3.8 Regional radiotherapy after NAC | 130 | 2.3% | OK |
| § 3.9 Certainty of evidence (GRADE SoF) | 186 | 3.3% | OK |
| § 3.10 Mapping to clinical-practice guidelines | 170 | 3.0% | OK |
| § 4.1 Principal findings | 171 | 3.0% | OK |
| § 4.2 Convergence vs divergence | 150 | 2.7% | OK |
| § 4.3 Methodological observations | 163 | 2.9% | OK |
| § 4.4 Strengths | 106 | 1.9% | OK |
| § 4.5 Limitations | **265** | 4.7% | **TIGHTEN** — 7 limitations (post my edit), candidate to compress to 5 sentences each rather than full paragraphs (~180 words). Or reorder to put post-hoc PICOS first. |
| § 4.6 Implications for clinical practice | 167 | 2.9% | OK |
| § 4.7 Implications for future research | 148 | 2.6% | OK (after Five → Four edit; could add a 5th if Sergio sees a missing priority) |
| § 5 Conclusions | 462 (incl. back-matter) | 8.1% | Conclusions narrative ~310 words — slightly long but defensible for the scope |

---

## 3. Reference, table, figure counts

| Item | Count | Notes |
|---|---|---|
| References (Vancouver-numbered) | **90** | 1-7 trials; 8-40 SRs (33 entries; 23 used post-triage; 10 carry "†" excluded marker per line 190); 41-55 cohorts/registries; 56-72 guidelines/methodology; 73-90 Discussion supplementary |
| Tables (.md files in `tables/`) | **7** | table1, table1A, table1B, table2, table3, table4, table5 |
| Tables referenced in manuscript body | **8** | Tables 1, 1A, 1B, 2, 3, 4, 5, 6 — **Table 6 cited but no `table6_*.md` exists** (file is `grade_table_for_results.md`; rename required) |
| Figures referenced in manuscript body | **5 unique** (cited 6× total) | Figures 1, 2, 3, 4, 6 — **Figure 5 is never explicitly named in the body** despite line 190 claiming "Figures 1-6" |
| Supplementary files referenced | S1, S2, S3, S4, S7, S8 named — **S5 and S6 absent from text; S4 used twice (excluded SRs + search strings)** | See `editorial_review_2026-05-14.md` Issue S3 |

---

## 4. Word-count compliance vs target journals

| Journal | Typical body word cap | Manuscript current | Margin | Action |
|---|---|---|---|---|
| **BJS (Br J Surg)** | 4,500-5,000 | ~5,700 (body, excl. abstract/refs/headers) | **+700 to +1,200 words** | **Tighten** §3.3 AMSTAR-2 (-200), §2.6 (-100), §4.5 Limitations (-80), §1 Introduction (-50) → save ~430 words. Then pre-clear longer limit with editor for the remaining margin. |
| **EJSO (Eur J Surg Oncol)** | 5,000 | ~5,700 | **+700 words** | Same as BJS |
| **Ann Surg Oncol** | 4,500 | ~5,700 | **+1,200 words** | Difficult — would need substantive trimming. Sergio decides. |
| **Annals of Surgery** | 5,000-6,000 | ~5,700 | OK | Acceptable |
| **The Breast** | 4,000-5,000 | ~5,700 | **+700-1,700 words** | Tighten as above |

**Recommendation:** If targeting BJS or EJSO, apply the recommended cuts to bring body to ~5,200 words and request editorial pre-clearance for the residual.

---

## 5. Tightening recommendations (priority-ranked)

### Priority 1 — § 3.3 Methodological quality (AMSTAR-2): trim from 614 to ~400 words
The four paragraphs (§3.3.a-d) overlap on AMSTAR-2 narrative:
- Paragraph 1 = consensus distribution per stratum (KEEP).
- Paragraph 2 = inter-rater κ (CONDENSE to 2 sentences).
- Paragraph 3 = item-level distribution (KEEP, but compress the bulleted item list to one sentence).
- Paragraph 4 = Samiei 2021 critically-low + 5-anchor SR list (CONSOLIDATE).

**Estimated saving:** ~200 words.

### Priority 2 — § 4.5 Limitations: trim from 265 to ~180 words
Each of the seven limitations is currently 30-50 words. Compress each to ≤25 words, then put the post-hoc PICOS triage limitation first (currently Seventh — see editorial review S13).

**Estimated saving:** ~85 words.

### Priority 3 — § 2.6 Methodological-quality assessment: trim from 405 to ~300 words
The 3-rater pipeline narrative repeats "Rater 1 / Rater 2 / Rater 3" with full descriptions. Consolidate into a single sentence per rater.

**Estimated saving:** ~100 words.

### Priority 4 — § 1 Introduction: trim from 624 to ~550 words
Paragraph 2 on the surgical-trials timeline (Z1071 → SENTINA → SN FNAC → MARI → TAD → RISAS → NSABP B-51) duplicates content that reappears in §3.5 and §3.8. Compress to one paragraph (~150 words from current ~250).

**Estimated saving:** ~100 words.

### Priority 5 — § 5 Conclusions: trim narrative from ~310 to ~250 words
The Conclusion currently restates §4.1, §4.2, §4.6 and §4.7 in compressed form. Sharpen by removing duplications.

**Estimated saving:** ~60 words.

**Total potential saving:** ~545 words → manuscript body 5,700 → ~5,155 words. Comfortable BJS / EJSO compliance.

---

## 6. Verdict

**Current word count:** 6,336 raw / ~5,700 body (manuscript text excluding refs and abstract/back-matter).
**Target for BJS submission:** 5,000 (with editor pre-clearance possible to 5,500).
**Recommendation:** Apply Priority 1-3 cuts immediately (saves ~385 words → body ~5,315). If targeting BJS specifically, also apply Priority 4-5 (additional ~160 words → body ~5,155).

Per-section per-paragraph distribution is otherwise well-balanced; no individual subsection (other than §3.3 and §4.5) exceeds 250 words.
