| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Original Article |
1 Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030
2 Department of Biostatistics and Applied Math, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030
3 Department of Pathology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Texas 77030
Correspondence: Address correspondence and reprint requests to: Funda Meric-Bernstam, MD; E-mail: fmeric{at}mdanderson.org.
Background: Although completion lymph node dissection (CLND) is the standard of care for breast cancer patients with sentinel lymph node (SLN) metastases, the SLN is the only node with tumor in 40% to 60% of cases. To assist with decision-making regarding CLND, investigators at Memorial Sloan-Kettering Cancer Center devised and validated a nomogram for predicting the likelihood of non-SLN metastases. To assess the generalizable use of this nomogram, validation analysis was performed by using an external database.
Methods: Eight clinicopathologic variables for 200 consecutive breast cancer patients at the University of Texas M. D. Anderson Cancer Center with SLN metastases and CLND were entered into the nomogram. The accuracy of the nomogram to predict non-SLN metastases was assessed by the receiver operating characteristic (ROC) curve and linear regression analysis. The accuracy of the nomogram with touch-imprint cytology (TIC) as a substitute variable for frozen section was also evaluated.
Results: The linear correlation coefficient of the nomogram-predicted probabilities correlated with the observed incidence of non-SLN metastases for all patients (.97). The accuracy of the nomogram as measured by the area under the ROC curve was .71. When applied solely to patients who had TIC assessment of the SLN, the area under the ROC curve was .74.
Conclusions: This study validated the Memorial Sloan-Kettering Cancer Center breast cancer nomogram by using an external database. TIC seems to be an acceptable substitute for frozen section as a nomogram variable. The nomogram may help predict an individual’s risk of non-SLN metastases and assist in patient decision making regarding the benefit of CLND.
Key Words: Sentinel node • Prediction • Nomogram • Breast cancer • Axillary lymph node dissection
This article has been cited by other articles:
 |
|
 |
|
  C. Coutant, C. Olivier, E. Lambaudie, E. Fondrinier, F. Marchal, F. Guillemin, N. Seince, V. Thomas, J. Leveque, E. Barranger, et al. Comparison of Models to Predict Nonsentinel Lymph Node Status in Breast Cancer Patients With Metastatic Sentinel Lymph Nodes: A Prospective Multicenter Study J. Clin. Oncol., June 10, 2009; 27(17): 2800 - 2808. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Mittendorf, A. A. Sahin, S. L. Tucker, F. Meric-Bernstam, M. Yi, K. M. Nayeemuddin, G. V. Babiera, M. I. Ross, B. W. Feig, H. M. Kuerer, et al. Lymphovascular Invasion and Lobular Histology are Associated with Increased Incidence of Isolated Tumor Cells in Sentinel Lymph Nodes from Early-Stage Breast Cancer Patients Ann. Surg. Oncol., December 1, 2008; 15(12): 3369 - 3383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. S. Cody III and K. J. Van Zee Predicting Nonsentinel Node Metastases in Sentinel Node-Positive Breast Cancer: What Have We Learned, Can We Do Better, and Do We Need To? Ann. Surg. Oncol., November 1, 2008; 15(11): 2998 - 3002. [Full Text] [PDF]
|
|
|
|
|
|
A. Pinero, M. Canteras, E. Ortiz, E. Martinez-Barba, and P. Parrilla Validation of a Nomogram to Predict the Presence of Sentinel Lymph Node Metastases in Melanoma Ann. Surg. Oncol., October 1, 2008; 15(10): 2874 - 2877. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Poirier, L. Sideris, P. Dube, P. Drolet, and S. H. Meterissian Analysis of Clinical Applicability of the Breast Cancer Nomogram for Positive Sentinel Lymph Node: The Canadian Experience Ann. Surg. Oncol., September 1, 2008; 15(9): 2562 - 2567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Samphao, J. M. Eremin, M. El-Sheemy, and O. Eremin Management of the Axilla in Women With Breast Cancer: Current Clinical Practice and a New Selective Targeted Approach Ann. Surg. Oncol., May 1, 2008; 15(5): 1282 - 1296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Van Zee and M. W. Kattan Validating a Predictive Model for Presence of Additional Disease in the Non Sentinel Lymph Nodes of a Woman with Sentinel Node Positive Breast Cancer Ann. Surg. Oncol., August 1, 2007; 14(8): 2177 - 2178. [Full Text] [PDF]
|
|
|
|
|
|
L. A. Lambert, G. D. Ayers, and F. Meric-Bernstam Validation of a Breast Cancer Nomogram for Predicting Nonsentinel Lymph Node Metastases after a Positive Sentinel Node Biopsy Ann. Surg. Oncol., August 1, 2007; 14(8): 2422 - 2423. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Pruthi, K. R. Brandt, A. C. Degnim, M. P. Goetz, E. A. Perez, C. A. Reynolds, P. J. Schomberg, G. K. Dy, and J. N. Ingle A Multidisciplinary Approach to the Management of Breast Cancer, Part 1: Prevention and Diagnosis Mayo Clin. Proc., August 1, 2007; 82(8): 999 - 1012. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Soran, T. Evrensel, G. Ahrendt, B. Kocer, and R. Johnson Use of the Breast Cancer Nomogram to Predict Non-Sentinel Nodal Positivity in Patients Having Received Pre-Operative Chemotherapy Ann. Surg. Oncol., January 1, 2007; 14(1): 165 - 165. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
