Models for predicting non-sentinel lymph node positivity in sentinel node positive breast cancer: the importance of scoring system

Ünal, Bülent; Gur, Akif Serhat; Kayıran, Oğuz; Johnson, R. R.; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

doi:10.1111/j.1742-1241.2008.01887.x

Cited by 33 publications

(36 citation statements)

References 42 publications

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“…In this study, mean number of negative SLNs was another factor affecting non-SLN positivity in univariate analysis but multifocality and nuclear grade were not related with non-SLN metastasis. We did not find the tumour type as a related factor with non-SLN metastasis similar to previous studies either [11,17].…”

Section: Discussionsupporting

confidence: 74%

“…In the present study, hormonal receptor status (ER, PR) did not affect the non-SLN metastasis risk however HER2 showed significance in univariate analysis. There are both contradicting and sustaining studies in literature about multifocality, nuclear grade and the number of negative SLNs [11,17,20,23,25,26]. In this study, mean number of negative SLNs was another factor affecting non-SLN positivity in univariate analysis but multifocality and nuclear grade were not related with non-SLN metastasis.…”

Section: Discussioncontrasting

confidence: 37%

“…However, only the positive SLN ratio showed significance in multivariate analysis (p=0.005). In previous studies on the topic, there was no relationship between non-SLN metastasis and ER, PR and HER2 status [17,[20][21][22][23]. In the present study, hormonal receptor status (ER, PR) did not affect the non-SLN metastasis risk however HER2 showed significance in univariate analysis.…”

Section: Discussionmentioning

confidence: 31%

“…For example, AfricanAmerican breast cancer patients are more likely to have a triple-negative (ER-/PR-/HER2-) subtype than Asian women [12]. For this reason, the validity of MSKCC nomogram is tested on patients who belong to various ethnic groups or socia-economic status by various centres and the results differ from one centre to another [13][14][15][16][17]. There are some other developed nomograms in literature to predict non-SLN status in patients with breast cancer with SLN metastasis as well; these Nomograms may be useful tools to avoid complete axillary dissection in non-SLN negative patients.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

The Accuracy of Memorial Sloan-Kettering Cancer Center Nomogram in Anatolian Breast Cancer Patients

Erdoğan¹,

Yuksel²,

Berberoğlu³

et al. 2016

Acta Oncol Tur.

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ÖZETAmaç: Bir çok meme kanseri hastasında sentinel lenf nodundan başka metastatik lenf nodu olmadığı halde gereksiz yere aksiller diseksiyon uygulanmaktadır. Bu çalışmanın amacı Memorial Sloan-Kettering Cancer Center (MSKCC) nomogramının Anadolu'da yaşayan meme kanseri hastalarındaki doğruluğunu araştırmaktır. Gereç ve yöntem: Sentinel lenf nodu (SLN) biyopsisi pozitif olduğu için aksiller lenf nodu diseksiyonu yapılan 120 meme kanserli hastanın hasta ve tümör özellikleri irdelendi. Bu hastaların her birisinin non-SLN tutulum riski MSKCC nomogramı kullanılarak hesaplandı. Bulgular: Negatif SLN sayısı, pozitif SLN sayısı, SLN ekstrakapsüler yayılımı, pozitif SLN sayısının toplam SLN sayısına oranı (pozitif SLN oranı), lenfovasküler invazyon varlığı, tumor çapı, human epidermal growth factor receptor-2 durumu tek değişkenli analizde non-SLN metastazı ile istatistiksel olarak ilişkili bulunan faktörlerdi. Çok değişkenli analizde ise tümör çapı ≥ 5cm (p<0.036) ve pozitif SLN oranı (p<0.005) non-SLN metastazı ile ilişkili bulunan parametrelerdi. Nomogramın sonucuna göre ROC eğrisi çizildi ve eğri altı alan 0,779 (p<0.001) olarak bulundu. Sonuç: SLN pozitif meme kanserli hastalarda non-SLN metastaz riskini belirlemede MSKCC nomogramı bizim hasta populasyonumuz için iyi bir ayıraç olmuştur. Anahtar kelimeler: Meme kanseri, nomogramlar, lenf nod diseksiyonu ABSTRACT Background and Aim: Many breast cancer patients undergo to unnecessary axillary dissection as additional nodal metastasis is not detected other than sentinel lymph node in most of the patients. This study is conducted to establish the accuracy of Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram in Anatolian patients. Materials and Methods: One hundred and twenty sentinel lymph node (SLN) biopsy positive breast cancer patients who received completion axillary lymph node dissection were reviewed according to patient and tumour characteristics. The likelihood of having positive non-SLN metastasis based on the factors and the performance of the diagnostic value of MSKCC nomogram were evaluated. Results: The number of negative SLNs, the number of positive SLNs, SLN extracapsular extention, proportion of positive SLNs to total SLNs (positive SLN ratio), lymphovascular invasion, tumor size, human epidermal growth factor receptor-2 status were found statistically significant on non-SLN metastasis in univariate analysis. Tumor size ≥ 5cm (p<0.036) and positive SLN ratio (p<0.005) were found to be correlated with non-SLN metastasis in multivariate analysis. Receiver operating characteristic (ROC) curve was formed according to the nomogram and areas under curve (AUC) was found as 0,779 (p<0.001). Conclusions: The MSKCC nomogram was good discriminator of non-SLN metastasis in SLN positive breast cancer patients for our patient population.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 31%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Accuracy of Memorial Sloan-Kettering Cancer Center Nomogram in Anatolian Breast Cancer Patients

Erdoğan¹,

Yuksel²,

Berberoğlu³

et al. 2016

Acta Oncol Tur.

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“…The results of the validation studies performed for the MSKCC nomogram, which was the first nomogram, are summarized in Table 4 (Unal et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Validation of Three Breast Cancer Nomograms and a New Formula for Predicting Non-sentinel Lymph Node Status

Derici¹,

Sevinç²,

Omer³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Outcome of selected breast cancer patients with micrometastasis or isolated tumor cells in sentinel node biopsy and no completion axillary lymph node dissection

Meretoja

Vironen

Heikkilä

et al. 2010

Journal of Surgical Oncology

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Models for predicting non-sentinel lymph node positivity in sentinel node positive breast cancer: the importance of scoring system

Abstract: Despite having some limitations, the MSKCC nomogram is the most validated model in the literature. These models should be tested and verified in different programs and different patient groups before they are widely accepted.

Cited by 33 publications

References 42 publications

The Accuracy of Memorial Sloan-Kettering Cancer Center Nomogram in Anatolian Breast Cancer Patients

The Accuracy of Memorial Sloan-Kettering Cancer Center Nomogram in Anatolian Breast Cancer Patients

Validation of Three Breast Cancer Nomograms and a New Formula for Predicting Non-sentinel Lymph Node Status

Outcome of selected breast cancer patients with micrometastasis or isolated tumor cells in sentinel node biopsy and no completion axillary lymph node dissection

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