Comparative Validation of Online Nomograms for Predicting Nonsentinel Lymph Node Status in Sentinel Lymph Node–Positive Breast Cancer

Abstract

Background: Completion axillary lymph node dissection is recommended for patients with metastases to the sentinel lymph node (SLN) in breast cancer although nonsentinel lymph nodes (NSLN) are often negative for tumor. Online nomograms are available to predict risk of NSLN disease.

Omission of Axillary Dissection According to ACOSOG Z0011: Impact on Adjuvant Treatment Recommendations

“…The clinical utility of nomograms predicting further nonsentinel lymph node metastases during completion ALND should be evaluated and might help to guide such decisions. [25][26][27][28][29] In addition, our results confirm a rate of approximately 13 % of patients meeting the ACOSOG Z0011 criteria to have four or more metastatic lymph nodes after ALND. According to the AGO trial, these patients might have improved survival if a dose-dense, dose-intense treatment is used.…”

A Breast Cancer Nomogram for Prediction of Non-Sentinel Node Metastasis - Validation of Fourteen Existing Models

“…Following the MSKCC model described by Van Zee et al, many models have been proposed and tested by many studies (Van Zee et al, 2003;Kocsis et al, 2004;Degnim et al, 2005;Smidt et al, 2005;Soni et al, 2005;Lambert et al, 2006;Alran et al, 2007;Ponzone et al, 2007;Cho et al,. 2008;Klar et al, 2008;Kohrt et al, 2008;Pal et al, 2008;Poirier et al, 2008;Coufal et al, 2009;Coutant et el., 2009;Scow et al, 2009;Gur et al, 2010;Moghaddam et al, 2010;Lombardi et al, 2011;Hessman et al, 2011;Hidar et al, 2011;Tan et al, 2011;Chen et al, 2012;Derici et al, 2012;Zhu et al, 2012;Sasada et al, 2013). The last proposed international model from multiple centers in Europe, however, has not been validated to date.…”

“…Many studies have tested these models and have obtained varying results (Van Zee et al, 2003;Kocsis et al, 2004;Degnim et al, 2005;Soni et al, 3 2005; Lambert et al, 2006;Ponzone et al, 2007;Pal et al, 2008;Kohrt et al, 2008;Cho et al, 2008;Klar et al, 2008;Poirier et al, 2008;Coufal et al, 2009;Coutant et el., 2009;Scow et al, 2009;Gur et al, 2010;Moghaddam et al, 2010;Hessman et al, 2011;Hidar et al, 2011;Lombardi et al, 2011;Tan et al, 2011;Derici et al, 2012;Chen et al, 2012;Zhu et al, 2012;Sasada et al, 2013).…”

“…2008;Klar et al, 2008;Kohrt et al, 2008;Pal et al, 2008;Poirier et al, 2008;Coufal et al, 2009; Coutant et el., 2009;Scow et al, 2009;Gur et al, 2010;Moghaddam et al, 2010;Hessman et al, 2011;Hidar et al, 2011;Lombardi et al, 2011;Tan et al, 2011;Chen et al, 2012;Derici et al,…”

A New Model for Predicting Non-Sentinel Lymph Node Status in Chinese Sentinel Lymph Node Positive Breast Cancer Patients

“…In 2008, a modified nomogram using only 3 histopathologic variables was developed at Stanford [12]. The SOC has demonstrated an AUC of 0.64 to 0.73 by validation that seems to perform better than the MSKCC nomogram [22]–[24].…”