Risk Factors for Sentinel Lymph Node Metastasis and Validation Study of the MSKCC Nomogram in Breast Cancer Patients

Qiu, Pengfei; Liu, Juanjuan; Wang, Yongsheng; Yang, Guoren; Liu, Yanbing; Sun, Xiao; Wang, Chunjian; Zhang, Zhao‐Peng

doi:10.1093/jjco/hys150

Cited by 45 publications

(46 citation statements)

References 26 publications

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“…Several nomograms, such as the MSKCC nomogram, have been developed to predict the likelihood of SLN metastasis only based on the clinicopathologic information including patient age, tumor size, tumor location, LVI, multifocality, histologic tumor type, etc. However, these nomograms and their following validation studies all failed to reach an AUC > 0.8 . In this study, we combined DCE‐MRI radiomic features with clinicopathologic characteristics to effectively improve the prediction performance, achieving a higher AUC of 0.869 on the independent validation set.…”

Section: Discussionmentioning

confidence: 95%

“…However, these nomograms and their following validation studies all failed to reach an AUC > 0.8. [11][12][13][14][15][16][17][18] In this study, we combined DCE-MRI radiomic features with clinicopathologic characteristics to effectively improve the prediction performance, achieving a higher AUC of 0.869 on the independent validation set. The prediction performance slightly decreased (AUC = 0.836) when validation set features were generated using ROIs drawn by a second reader.…”

Section: Discussionmentioning

confidence: 99%

“…11 However, the area under the receiver operating characteristic (ROC) curve (AUC) was relatively low at 0.754, which hinders its clinical adoption. Although several similar nomograms [12][13][14] and validation studies [15][16][17][18] were published later, the reported AUC values were all lower than 0.8, which is insufficient to reliably guide clinical practice.…”

mentioning

confidence: 99%

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Preoperative prediction of sentinel lymph node metastasis in breast cancer by radiomic signatures from dynamic contrast‐enhanced MRI

Liu

Ding

Spuhler

et al. 2018

Magnetic Resonance Imaging

171

155

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Preoperative prediction of sentinel lymph node metastasis in breast cancer by radiomic signatures from dynamic contrast‐enhanced MRI

Liu

Ding

Spuhler

et al. 2018

Magnetic Resonance Imaging

171

155

View full text Add to dashboard Cite

show abstract

“…Nevertheless, Alran et al analyzed patients with SLN micrometastasis, but found no predictive value, with an AUC of 0.53 19. Even so, many research scholars still consider that MSKCC nomograms can be used to assess the risk of non-SLN metastasis and provide reliable prediction analysis 20,21…”

Section: Discussionmentioning

confidence: 99%

Validation of the Memorial Sloan Kettering Cancer Center nomogram for predicting non-sentinel lymph node metastasis in sentinel lymph node-positive breast-cancer patients

Bi¹,

Wang²,

Li³

et al. 2015

OTT

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BackgroundThe main purpose of the study reported here was to validate the clinical value of the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram that predicts non-sentinel lymph node (SLN) metastasis in SLN-positive patients with breast cancer.MethodsData on 1,576 patients who received sentinel lymph node biopsy (SLNB) at the Shandong Cancer Hospital from December 2001 to March 2014 were collected in this study, and data on 509 patients with positive SLN were analyzed to evaluate the risk factors for non-SLN metastasis. The MSKCC nomogram was used to estimate the probability of non-SLN metastasis and was compared with actual probability after grouping into deciles. A receiver-operating characteristic (ROC) curve was drawn and predictive accuracy was assessed by calculating the area under the ROC curve.ResultsTumor size, histological grade, lymphovascular invasion, multifocality, number of positive SLNs, and number of negative SLNs were correlated with non-SLN metastasis (P<0.05) by univariate analysis. However, multivariate analysis showed that tumor size (P=0.039), histological grade (P=0.043), lymphovascular invasion (P=0.001), number of positive SLNs (P=0.001), and number of negative SLNs (P=0.000) were identified as independent predictors for non-SLN metastasis. The trend of actual probability in various decile groups was comparable to the predicted probability. The area under the ROC curve was 0.722. Patients with predictive values lower than 10% (97/492, 19.7%) had a frequency of non-SLN metastasis of 17.5% (17/97).ConclusionThe MSKCC nomogram can provide an accurate prediction of the probability of non-SLN metastasis, and offers a reference basis about axillary lymph node dissection. Axillary lymph node dissection could be avoided in patients with predictive values lower than 10%.

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“…The aim of this study was to determine, in a large series of patients with primary invasive breast cancer treated initially by surgery, whether SWE findings could independently predict lymph node status when taking known predictors of nodal status such as invasive size, histological grade and vascular invasion status [ 11 , 12 ] into account. If SWE finding are predictive of lymph node involvement this may be clinically useful in selecting patients for neo-adjuvant chemotherapy (NACT), as the established predictors of nodal involvement are only definitively available post operatively, and ultrasound guided percutaneous biopsy of nodes with abnormal ultrasound morphology only establishes a diagnosis of nodal metastases in around 50 % of cases shown to be positive at surgery [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer?

Evans

Rauchhaus

Whelehan

et al. 2013

Breast Cancer Res Treat

101

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Shear wave elastography (SWE) shows promise as an adjunct to greyscale ultrasound examination in assessing breast masses. In breast cancer, higher lesion stiffness on SWE has been shown to be associated with features of poor prognosis. The purpose of this study was to assess whether lesion stiffness at SWE is an independent predictor of lymph node involvement. Patients with invasive breast cancer treated by primary surgery, who had undergone SWE examination were eligible. Data were retrospectively analysed from 396 consecutive patients. The mean stiffness values were obtained using the Aixplorer® ultrasound machine from SuperSonic Imagine Ltd. Measurements were taken from a region of interest positioned over the stiffest part of the abnormality. The average of the mean stiffness value obtained from each of two orthogonal image planes was used for analysis. Associations between lymph node involvement and mean lesion stiffness, invasive cancer size, histologic grade, tumour type, ER expression, HER-2 status and vascular invasion were assessed using univariate and multivariate logistic regression. At univariate analysis, invasive size, histologic grade, HER-2 status, vascular invasion, tumour type and mean stiffness were significantly associated with nodal involvement. Nodal involvement rates ranged from 7 % for tumours with mean stiffness <50 kPa to 41 % for tumours with a mean stiffness of >150 kPa. At multivariate analysis, invasive size, tumour type, vascular invasion, and mean stiffness maintained independent significance. Mean stiffness at SWE is an independent predictor of lymph node metastasis and thus can confer prognostic information additional to that provided by conventional preoperative tumour assessment and staging.

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Risk Factors for Sentinel Lymph Node Metastasis and Validation Study of the MSKCC Nomogram in Breast Cancer Patients

Cited by 45 publications

References 26 publications

Preoperative prediction of sentinel lymph node metastasis in breast cancer by radiomic signatures from dynamic contrast‐enhanced MRI

Preoperative prediction of sentinel lymph node metastasis in breast cancer by radiomic signatures from dynamic contrast‐enhanced MRI

Validation of the Memorial Sloan Kettering Cancer Center nomogram for predicting non-sentinel lymph node metastasis in sentinel lymph node-positive breast-cancer patients

Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer?

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