A Scoring System to Predict Nonsentinel Lymph Node Status in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes: A Comparison with Other Scoring Systems

Cho, Jihyoung; Han, Wonshik; Lee, Jong Won; Ko, Eunyoung; Kang, So Young; Jung, Sung Eun; Kim, Eun‐Kyu; Moon, Wookyung; Cho, Nariya; Park, In-Ae; Chung, Jun Key; Hwang, Kihwan; Kim, Sung Won; Noh, Dong‐Young

doi:10.1245/s10434-008-9993-z

Cited by 44 publications

(39 citation statements)

References 34 publications

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“…This result stated the aggravated risk corolated with tumour size. In the present study; LVI, the number of positive SLNs, extracapsular extension and the positive SLN ratio (proportion of positive SLN to total SLN) were the other factors affecting non-SLN metastasis risk in univariate analysis compatible with literature [22][23][24]. However, only the positive SLN ratio showed significance in multivariate analysis (p=0.005).…”

Section: Discussionsupporting

confidence: 79%

“…Tumour size is also reported as a related factor with non-SLN metastasis in some other various studies [21][22][23]. In our study, there was significance between the non-SLN positive and negative groups according to mean tumour size (p=0.002) and in multivariate analysis tumour size over 5 cm.…”

Section: Discussionsupporting

confidence: 72%

“…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: Discussioncontrasting

confidence: 53%

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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: 79%

Section: Discussionsupporting

confidence: 72%

Section: Discussioncontrasting

confidence: 53%

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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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“…Therefore, we considered SLN micrometastasis as the most important negative predictive factor of NSLN involvement in IBC patients with SLN metastasis. Since Van Zee and colleagues reported the use of a nomogram to calculate the likelihood of metastases in NSLNs (42), several other groups have proposed new predictive models (43)(44)(45)(46) and compared their predictive probabilities (47,48). These studies have suggested that the nomograms might be good discriminators of NSLN metastases in SLNpositive IBC patients, but because of their limitations and imperfections they should be used with caution in clinical applications (42)(43)(44)(45)(46)(47)(48).…”

Section: ------------------------------------------------Factors Oddsmentioning

confidence: 99%

Clinicopathological parameters and biological markers predicting non-sentinel node metastasis in sentinel node-positive breast cancer patients

Kwon

Kang

et al. 2011

Oncol Rep

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Abstract. The value of complete axillary lymph node dissection (ALND) has been questioned in invasive breast cancer (IBC) patients with positive sentinel lymph nodes (SLNs) who have no non-sentinel lymph node (NSLN) metastases. Because biological markers have not been systematically studied in this setting, we sought to identify clinicopathological characteristics and biological markers for predicting NSLN metastases in SLN-positive IBC patients. Two hundred and five IBC patients who had at least one positive SLN and received SLN biopsy and ALND were included in our study. We examined the clinicopathological characteristics of their primary tumors, SLNs and NSLNs. We also evaluated the biological markers of the primary tumors by tissue microarray and immunohistochemistry. Of the 205 patients with SLN metastases, 89 patients (43.4%) had additional metastases in NSLNs. The following factors were found to be associated with NSLN metastases: peritumoral lymphovascular invasion (p=0.01), two or more metastatic SLNs (p<0.01), SLN metastasis >2.0 mm (p<0.01) and extranodal extension (p<0.01). Primary tumors >2.0 cm showed more NSLN metastases, but the association was statistically insignificant (p=0.08). In contrast, NSLN metastases were not associated with histologic grade, histologic type, presence of extensive intraductal component, presence of high grade ductal carcinoma in situ and number of harvested SLNs. Biological markers such as E-cadherin, CD44, cyclin D1, p21, ER, PR, c-erbB2, p53, Ki-67, luminal (CK7, CK18, CK19) and basal (CK5, p63) markers were not useful predictors of NSLN metastasis in IBC patients with SLN metastases. Multivariate analysis revealed that SLN metastasis >2.0 mm (p=0.01), two or more metastatic SLNs (p=0.03) and extranodal extension (p<0.01) were independent predictors of NSLN metastasis. For the prediction of NSLN metastasis in IBC patients with SLN metastases, light microscopic evaluation of the number, size and extranodal extension of metastatic SLNs by hematoxylin and eosin staining appeared to be critical. However, the biological markers of primary tumor characterized by immunohistochemical staining, such as luminal and basal markers, hormone receptors, E-cadherin, CD44, cyclin D1, p21, c-erb-B2, p53 and Ki-67, did not appear to be helpful predictors.

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“…To avoid performing ALND for non-SLN-negative patients with SLN-positive axilla, nomograms and scoring systems for predicting the status of the axillary non-SLNs have been developed in many centers (Van Zee et al, 2003;Degnim et al, 2005;Smidt et al, 2005;Chapgar et al, 2006;Pal et al, 2008;Alran et al, 2007;Kohrt et al, 2008;Cho et al, 2008;Coufal et al, 2009;Gur et al, 2010;Perhavec et al, 2010;Lombardi, et al, 2011;Mittendorf et al, 2012;Meretoja et al, 2012;Derici et al, 2012). 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).…”

Section: Introductionmentioning

confidence: 99%

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

Koca

Kuru²,

Özen³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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A Scoring System to Predict Nonsentinel Lymph Node Status in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes: A Comparison with Other Scoring Systems

Cited by 44 publications

References 34 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

Clinicopathological parameters and biological markers predicting non-sentinel node metastasis in sentinel node-positive breast cancer patients

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

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