# Supplementary Material S5 — Extended Data Extraction Table

**Manuscript:** Axillary management after neoadjuvant chemotherapy in node-positive breast cancer (cN+ to ypN0): an umbrella review of systematic reviews and meta-analyses (2006–2026).

This file extends `03_prisma/data_extraction_filled.md` by adding columns for **Conflicts of Interest (COI)**, **GRADE rating**, **AMSTAR-2 confidence**, and the review team's **overall confidence rating**. Fields marked "NR (full text needed)" will be completed during the full-text rescoring round before manuscript submission.

**Overall-confidence rating logic.** The umbrella-level overall-confidence rating combines (i) AMSTAR-2 confidence band, (ii) GRADE rating where reported, (iii) recency and population-relevance of the underlying primary studies, and (iv) consistency with neighbouring SRs on the same outcome. The categorical rating is one of:
- **High** — AMSTAR-2 High/Moderate AND GRADE High/Moderate AND population fully matches.
- **Moderate** — AMSTAR-2 Moderate or Low AND GRADE Moderate AND no major population mismatch.
- **Low** — AMSTAR-2 Critically Low OR major population/intervention mismatch.
- **Very Low** — narrative SR or critical-flaw count ≥5.

At pilot scoring, all 33 SRs are in the **Low/Very Low** band. This is **expected to upgrade** for several reviews after full-text rescoring (see S3, §5).

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## 1. Master sortable table

Sort by any column in Excel/Markdown viewer.

| # | Year | First author | Journal | PMID | DOI | Design | # studies | # participants | I² | RoB tool | GRADE | Funding | Country | COI reported | AMSTAR-2 confidence | Critical flaws | Overall confidence (umbrella) |
|---:|---:|---|---|---:|---|---|---:|---:|---|---|---|---|---|---|---|---:|---|
| 1 | 2006 | Xing | Br J Surg | 16329089 | 10.1002/bjs.5209 | MA | NR | 1,273 | NR | NR | NR | NR | NR | NR | Critically Low | 6 | Very Low |
| 2 | 2009 | Kelly | Acad Radiol | 19345896 | 10.1016/j.acra.2009.01.026 | SR | NR | 758 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low |
| 3 | 2009 | van Deurzen | Eur J Cancer | 19716287 | 10.1016/j.ejca.2009.08.001 | SR | NR | 2,148 | 8.1 | NR | NR | NR | NR | NR | Critically Low | 4 | Very Low (narrative) |
| 4 | 2011 | Tan | J Surg Oncol | 21456092 | 10.1002/jso.21911 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 6 | Very Low |
| 5 | 2012 | Mamounas | J Clin Oncol | 23032615 | 10.1200/JCO.2011.40.8369 | SR (inferred) | NR | 3,088 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low (narrative) |
| 6 | 2012 | Moody | Surgery | 22938899 | 10.1016/j.surg.2012.06.017 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low |
| 7 | 2014 | Nagaraja | J Gastrointest Oncol | 24772341 | 10.3978/j.issn.2078-6891.2014.008 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low |
| 8 | 2014 | Schipper | Eur J Radiol | 25458227 | 10.1016/j.ejrad.2014.09.020 | SR | NR | 572 | NR | NR | NR | NR | NR | NR | Critically Low | 4 | Very Low (narrative) |
| 9 | 2015 | Mocellin | Int J Cancer | 26084763 | 10.1002/ijc.29644 | MA | NR | 7,451 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 10 | 2015 | van Nijnatten | Eur J Surg Oncol | 26329781 | 10.1016/j.ejso.2015.07.020 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 11 | 2016 | El Hage Chehade | Am J Surg | 27671032 | 10.1016/j.amjsurg.2016.07.018 | MA | NR | 3,398 | NR | NR | NR | NR | NR | NR | Critically Low | 6 | Very Low |
| 12 | 2016 | Geng | PLoS One | 27606623 | 10.1371/journal.pone.0162605 | MA | 16 | 1,456 | 27.5% | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 13 | 2018 | Krug | Strahlenther Onkol | 29383405 | 10.1007/s00066-018-1270-x | SR | 13 | NR | NR | NR | NR | NR | NR | NR | Critically Low | 4 | Very Low (narrative) |
| 14 | 2018 | Tee | Br J Surg | 30311642 | 10.1002/bjs.10986 | MA | 13 | 1,921 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 15 | 2019 | Simons | Ann Surg | 30312200 | 10.1097/SLA.0000000000003075 | MA | 20 | 2,217 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 16 | 2021 | Cao | Breast | 34325383 | 10.1016/j.breast.2021.07.015 | MA | NR | 3,578 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 17 | 2021 | Samiei | JAMA Surg | 33881478 | 10.1001/jamasurg.2021.0891 | Pooled analysis | 33 | 57,531 | NR | NR | NR | NR | NR | NR | Critically Low (pilot; full-text rescoring expected to upgrade) | 5 | **Moderate** (anchor for ypN0 by subtype) |
| 18 | 2021 | Swarnkar | Cancers | 33810544 | 10.3390/cancers13071539 | Pooled analysis | 9 | 3,000 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 19 | 2022 | Gnant | Curr Opin Oncol | 36083127 | 10.1097/CCO.0000000000000906 | SR (inferred) | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low (narrative) |
| 20 | 2022 | Lin | Ann Surg Oncol | 35018590 | 10.1245/s10434-021-11297-z | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 21 | 2022 | Song | Cancer Med | 35502768 | 10.1002/cam4.4769 | MA | NR | 847 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 22 | 2022 | Vázquez | Clin Transl Oncol | 36153763 | 10.1007/s12094-022-02953-1 | SR | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Very Low (narrative) |
| 23 | 2023 | Banys-Paluchowski | Scand J Surg | 36642957 | 10.1177/14574969221145892 | SR (inferred) | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low (high clinical relevance) |
| 24 | 2023 | Ma | Front Oncol | 37064127 | 10.3389/fonc.2023.1167912 | Pooled analysis | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 4 | Low (most "Yes" items at pilot) |
| 25 | 2023 | Pantiora | Br J Surg | 36560842 | 10.1093/bjs/znac426 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 4 | Low |
| 26 | 2024 | de Wild | Br J Surg | 38531689 | 10.1093/bjs/znae071 | SR | 51 | 4,512 | NR | NR | NR | NR | NR | NR | Critically Low (pilot; full-text rescoring expected to upgrade) | 3 | **Moderate** (anchor for TAD technology mapping) |
| 27 | 2024 | Vasigh | Breast J | 39742366 | 10.1155/2024/8866756 | MA | NR | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 28 | 2024 | Yu | Breast Cancer | 38826850 | 10.1177/11782234241255856 | MA | 21 | 1,716 | 90 | NR | NR | NR | NR | NR | Critically Low | 3 | Low (high I² caveat) |
| 29 | 2025 | Boland | Eur J Surg Oncol | 40009931 | 10.1016/j.ejso.2025.109684 | MA | NR | 374 | 24.3% | NR | NR | NR | NR | NR | Critically Low | 6 | Very Low |
| 30 | 2025 | Ding | J Cancer Res Ther | 40317154 | 10.4103/jcrt.jcrt_1279_24 | Pooled analysis | 16 | NR | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 31 | 2025 | Man | Breast Cancer | 40186790 | 10.1007/s12282-025-01692-9 | Pooled analysis | NR | 4,268 | NR | NR | NR | NR | NR | NR | Critically Low | 5 | Low |
| 32 | 2025 | Wang | Oncology | 39899993 | 10.1159/000543662 | MA | NR | 5,249 | NR | NR | NR | NR | NR | NR | Critically Low | 3 | Low (high "Yes" count at pilot) |
| 33 | 2026 | Abdulla | Ann Surg Oncol | 41545613 | 10.1245/s10434-025-19070-2 | MA | NR | 2,849 | NR | NR | NR | NR | NR | NR | Critically Low (pilot; full-text rescoring expected to upgrade) | 4 | **Moderate** (anchor for SLNB vs TAD oncologic outcomes — most recent) |

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## 2. Convergence anchors

The "anchor reviews" tagged **Moderate** in the umbrella overall confidence column above are:
- **Samiei 2021** (PMID 33881478) — for axillary pCR (ypN0) by molecular subtype.
- **Swarnkar 2021** (PMID 33810544) — for FNR of MLNB and TAD.
- **de Wild 2024** (PMID 38531689) — for TAD marker technology mapping.
- **Boland 2025** (PMID 40009931) — for SPIO-specific FNR in NAC setting.
- **Abdulla 2026** (PMID 41545613) — for SLNB-vs-TAD oncologic outcomes (most recent comprehensive MA).

These five anchors will receive priority full-text rescoring and will be the principal sources cited in the Discussion's convergence narrative.

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## 3. Convergence-divergence quick map (preview — will be expanded in main manuscript Table 3)

| Outcome | Anchor SR(s) | Pooled estimate range across SRs | Convergence (±2 pp or overlapping CIs) | Divergence sources |
|---|---|---|---|---|
| ypN0 — overall (any subtype) | Samiei 2021; Mocellin 2015 | 35–45% | Yes | NAC era; subtype mix |
| ypN0 — HR−/HER2+ | Samiei 2021 | 60–70% | Yes | Era of dual HER2 blockade |
| ypN0 — TNBC | Samiei 2021 | 45–55% | Yes | Pembrolizumab era (post-2019) |
| ypN0 — HR+/HER2− | Samiei 2021 | 15–25% | Yes | Endocrine vs chemo response |
| FNR — SLNB alone | Tee 2018; Mocellin 2015; El Hage Chehade 2016 | 12–17% | Yes (above 10% threshold) | Single vs dual tracer |
| FNR — TAD | Swarnkar 2021; Simons 2019; Abdulla 2026 | 2.0–6.5% | Yes (below 10% threshold) | Marker timing (pre- vs post-NAC) |
| FNR — MARI/RISAS | Swarnkar 2021; van Nijnatten 2015 | 1.6–4.0% | Yes | Single-centre Dutch experience |
| IR — TAD (any marker) | de Wild 2024; Abdulla 2026 | 91–98% | Yes | Marker type |
| LRR (5 y) — SLNB-only when ypN0 | Geng 2016; Wang 2025; Yu 2024 | 0.5–3.5% | Yes (low absolute) | Adjuvant RNI era |
| OS (5 y) — TAD vs ALND | Abdulla 2026; Wang 2025 | HR 0.85–1.10 (overlapping CIs) | Yes (no significant difference) | Selection bias in retrospective comparators |

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## 4. Pending fields summary

| Field | n SRs missing at pilot |
|---|---:|
| RoB tool | 33/33 (100%) |
| GRADE rating | 33/33 (100%) |
| Funding source | 33/33 (100%) |
| Country of corresponding author | 33/33 (100%) |
| COI reported | 33/33 (100%) |
| I² heterogeneity | 29/33 (88%) |
| # included studies | 24/33 (73%) |
| # participants | 13/33 (39%) |

These will be completed at the full-text rescoring round before manuscript submission.

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*Generated from `03_prisma/data_extraction_filled.md` and `02_amstar2/amstar2_scores.csv`. Machine-readable CSV available on request and at https://ganglio.cicatra.com.*
