BACKGROUND: It is debated whether all patients with a positive sentinel node dissection (SLND) should be submitted to axillary lymph node dissection (ALND). Models have been developed to estimate the likelihood of nonsentinel node (non-SLN) metastases. METHODS: The accuracy of the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and MD Anderson scoring system for the prediction of non-SLN status was tested in a consecutive series of 186 SLN-positive breast cancer patients. A multivariate analysis was performed to assess which parameters independently predicted the presence of non-SLN metastases. RESULTS: The predictive accuracy of the MSKCC nomogram measured by the receiver operating characteristic curve was 0.71, and it was best in patients with <10% risk of non-SLN metastases (sensitivity 100% and specificity 96%). The MD Anderson score predicted non-SLN involvement with low accuracy because it classified 85% of the patients in the intermediate-risk groups. Only SLN macrometastases and tumor multifocality independently predicted non-SLNs involvement. CONCLUSIONS: The MSKCC nomogram can help individualize the surgical treatment of SLN-positive breast cancer when the likelihood of further axillary involvement is low or surgical risks are higher.
BACKGROUND: It is debated whether all patients with a positive sentinel node dissection (SLND) should be submitted to axillary lymph node dissection (ALND). Models have been developed to estimate the likelihood of nonsentinel node (non-SLN) metastases. METHODS: The accuracy of the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and MD Anderson scoring system for the prediction of non-SLN status was tested in a consecutive series of 186 SLN-positive breast cancerpatients. A multivariate analysis was performed to assess which parameters independently predicted the presence of non-SLNmetastases. RESULTS: The predictive accuracy of the MSKCC nomogram measured by the receiver operating characteristic curve was 0.71, and it was best in patients with <10% risk of non-SLNmetastases (sensitivity 100% and specificity 96%). The MD Anderson score predicted non-SLN involvement with low accuracy because it classified 85% of the patients in the intermediate-risk groups. Only SLN macrometastases and tumor multifocality independently predicted non-SLNs involvement. CONCLUSIONS: The MSKCC nomogram can help individualize the surgical treatment of SLN-positive breast cancer when the likelihood of further axillary involvement is low or surgical risks are higher.
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Authors: J L Fougo; M Afonso; F Senhorães Senra; T Dias; C Leal; C Araújo; M Dinis-Ribeiro Journal: Clin Transl Oncol Date: 2009-03 Impact factor: 3.405
Authors: Oldrich Coufal; Tomás Pavlík; Pavel Fabian; Rita Bori; Gábor Boross; István Sejben; Róbert Maráz; Jaroslav Koca; Eva Krejcí; Iva Horáková; Vendula Foltinová; Pavlína Vrtelová; Vojtech Chrenko; Wolde Eliza Tekle; Mária Rajtár; Mihály Svébis; Vuk Fait; Gábor Cserni Journal: Pathol Oncol Res Date: 2009-05-15 Impact factor: 3.201
Authors: Holbrook E Kohrt; Richard A Olshen; Honnie R Bermas; William H Goodson; Douglas J Wood; Solomon Henry; Robert V Rouse; Lisa Bailey; Vicki J Philben; Frederick M Dirbas; Jocelyn J Dunn; Denise L Johnson; Irene L Wapnir; Robert W Carlson; Frank E Stockdale; Nora M Hansen; Stefanie S Jeffrey Journal: BMC Cancer Date: 2008-03-04 Impact factor: 4.430