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10.1245/s10434-006-9223-5
Annals of Surgical Oncology 14:1014-1019 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Evaluation of Three Scoring Systems Predicting Non Sentinel Node Metastasis in Breast Cancer Patients with a Positive Sentinel Node Biopsy

Christine E. Dauphine1, Jason S. Haukoos2,3, Maria P. Vargas1, Nova M. Isaac1, Iraj Khalkhali4 and Hernan I. Vargas1

1 Department of Surgery, Harbor-UCLA Medical Center, Torrance, California, USA
2 Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado, USA
3 Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, USA
4 Department of Radiology, Harbor-UCLA Medical Center, Torrance, California, USA

Correspondence: Address correspondence and reprint requests to: Hernan I. Vargas; Section of Surgical Oncology, 1000 West Carson Street, Box 25, Torrance, CA 90502, USA; E-mail: hvargas{at}ucla.edu

Background: Completion axillary lymph node dissection (cALND), performed after a positive sentinel lymph node biopsy (SLNB) in breast cancer patients, often results in no additional positive nodes. Scoring systems have been published to aid in the prediction of nonsentinel node metastasis. Our purpose was to assess the validity of these scoring systems in our patient population.

Methods: For 39 consecutive patients who underwent cALND after a positive SLNB, scores were calculated using retrospective patient data for each of the three scoring systems used. Receiver operating characteristics (ROC) curves were drawn, and the areas under the curves were calculated to assess the discriminative power of each system. Univariate analysis was performed to assess the predictability of individual patient and tumor characteristics.

Results: Nonsentinel nodes were positive in 23 (59%) patients. The areas under the ROC curves were 0.63, 0.70, and 0.68, respectively. The proportion of sentinel nodes that were positive and the total number of sentinel nodes retrieved were the only individual predictors of nonsentinel node metastasis.

Conclusions: Given the high incidence of retrieving no additional metastasis on cALND, individualized patient management according to risk is desirable. Scoring systems provide additional information regarding the likelihood of metastasis in nonsentinel nodes, but their predictability remains less than optimal. The use of scoring systems must be applied with caution until future studies provide a more accurate assessment of risk for patients with a positive SLNB.

Key Words: Scoring systems • Sentinel node • Nonsentinel node • Breast cancer




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 Ann. Surg. Oncol.Home page
E. Barranger, O. Morel, and C. Coutant
Axilla Scoring Systems Predicting Risk of Non-sentinel-node Metastasis in Breast Cancer Patients with a Positive Sentinel Node
Ann. Surg. Oncol., April 1, 2008; 15(4): 1261 - 1262.
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Home page
 Ann. Surg. Oncol.Home page
C. Dauphine
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Ann. Surg. Oncol., April 1, 2008; 15(4): 1263 - 1264.
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