Doctor, What Are My Chances of Having a Positive Sentinel Node? A Validated Nomogram for Risk Estimation

2007 ◽  
Vol 25 (24) ◽  
pp. 3670-3679 ◽  
Author(s):  
José Luiz B. Bevilacqua ◽  
Michael W. Kattan ◽  
Jane V. Fey ◽  
Hiram S. Cody ◽  
Patrick I. Borgen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Center ◽  
Tumor Type ◽  
Data Set ◽  
Specific Patient ◽  
Node Metastasis ◽  
Pathologic Features

Purpose Lymph node metastasis is a multifactorial event. Several variables have been described as predictors of lymph node metastasis in breast cancer. However, it is difficult to apply these data—usually expressed as odds ratios—to calculate the probability of sentinel lymph node (SLN) metastasis for a specific patient. We developed a user-friendly prediction model (nomogram) based on a large data set to assist in predicting the presence of SLN metastasis. Patients and Methods Clinical and pathologic features of 3,786 sequential SLN biopsy procedures were assessed with multivariable logistic regression to predict the presence of SLN metastasis in breast cancer. The model was subsequently applied to 1,545 sequential SLN biopsies. A nomogram was created from the logistic regression model. A computerized version of the nomogram was developed and is available on the Memorial Sloan-Kettering Cancer Center (New York, NY) Web site. Results Age, tumor size, tumor type, lymphovascular invasion, tumor location, multifocality, and estrogen and progesterone receptors were associated with SLN metastasis in multivariate analysis. The nomogram was accurate and discriminating, with an area under the receiver operating characteristic curve of 0.754 when applied to the validation group. Conclusion Newly diagnosed breast cancer patients are increasingly interested in information about their disease. This nomogram is a useful tool that helps physicians and patients to accurately predict the likelihood of SLN metastasis.

scholarly journals Age-dependent heterogeneity of lymph node metastases and survival in breast cancer: A population-based study

2021 ◽  
Author(s):  
Michael Behring ◽  
Sumit Agarwal ◽  
Prachi Bajpai ◽  
Amr Elkholy ◽  
Hyung-Gyoon Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Age Of Onset ◽  
Young Age ◽  
Receptor Subtype ◽  
Node Metastasis ◽  
Pathologic Features ◽  
Age Dependent ◽  
Age Of Diagnosis

AbstractBackgroundFor several cancers, including those of the breast, young age at diagnosis is associated with an adverse prognosis. Although this effect is often attributed to heritable mutations such as BRCA1/2, the relationship between pathologic features, young age of onset, and prognosis for breast cancer remains unclear. In the present study, we highlight links between age of onset and lymph node metastasis (NM) in US women with breast cancer.MethodsCase listings from Surveillance, Epidemiology, and End Result (SEER) 18 registry data for women with breast cancer, which include information on race, were used. NM and its associated outcomes were evaluated for a subset of women with receptor subtype information and then compared against a larger, pre-subtype validation set of data from the same registry. Age of diagnosis was a 5-category variable; under 40 years, 40-49 years, 50-59 years, 60-69 years and 70+ years. Univariate and adjusted multivariate survival models were applied to both sets of data.ResultsAs determined with adjusted logistic regression models, women under 40 years old at diagnosis had 1.55 times the odds of NM as women 60-69 years of age. The odds of NM for (HR = hormone receptor) HR+/HER2+, HR-/HER2+, and triple-negative breast cancer subtypes were significantly lower than those for HR+/HER2-. In subtype-stratified adjusted models, age of diagnosis had a consistent trend of decreasing odds of NM by age category, most noticeable for HR+ subtypes of luminal A and B. Univariate 5-year survival by age was worst for women under 40 years, with NM attributable for 49% of the hazard of death from cancer in adjusted multivariate models.ConclusionsLymph node metastasis is age-dependent, yet not all molecular subtypes are clearly affected by this relationship. For <40-yr-old women, NM is a major cause for shorter survival. When stratified by subtype, the strongest associations were in HR+ groups, suggesting a possible hormonal connection between young age of breast cancer onset and NM.

Nomogram for the Prediction of Having Four or More Involved Nodes for Sentinel Lymph Node–Positive Breast Cancer

2008 ◽  
Vol 26 (13) ◽  
pp. 2093-2098 ◽  
Author(s):  
Angela Katz ◽  
Barbara L. Smith ◽  
Mehra Golshan ◽  
Andrzej Niemierko ◽  
Wendy Kobayashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Axillary Dissection ◽  
Multivariate Logistic Regression Analysis ◽  
Published Data ◽  
Multivariate Logistic Regression ◽  
Data Set ◽  
Pathologic Features

Purpose The standard of care for patients with a positive (+) sentinel lymph node (SLN) is axillary dissection; however, for various reasons, some SLN+ patients do not undergo dissection. The purpose of this study was to define possible predictors of having four or more involved nodes to provide information for clinicians and patients making decisions about adjuvant chemotherapy and radiation. Patients and Methods We reviewed the records of 402 patients with invasive breast cancer and one to three involved SLNs who underwent completion axillary dissection at two academic cancer centers. None of these patients received neoadjuvant chemotherapy. Factors associated with having four or more involved axillary nodes (SLNs and non-SLNs) were evaluated by univariate and multivariate logistic regression analysis. Results Eighty-seven patients had four or more positive nodes. On multivariate analysis, having four or more SLNs was associated with tumor histology, primary tumor size, lymphovascular space invasion, extranodal extension, the number of involved SLNs, the number of uninvolved SLNs, and the size of the largest SLN metastasis. A nomogram to predict the probability of having four or more nodes based on patients’ pathologic data was developed from the multivariate logistic regression model. A separate previously published data set of 206 SLN+ patients treated at a community hospital in another city was used to validate this model. Conclusion Patients with a low probability of having four or more nodes can be identified from known pathologic features. The nomogram developed will be helpful to clinicians making adjuvant treatment recommendations.

A logistic regression nomogram to predict axillary lymph node metastasis in early invasive breast cancer patients

2019 ◽  
Vol 25 (4) ◽  
pp. 769-771 ◽  
Author(s):  
Masoomeh Sadeghi ◽  
Seyed‐Ali Alamdaran ◽  
Parnaz Daneshpajouhnejad ◽  
Parvaneh Layegh ◽  
Monavvar Afzalaghaee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Invasive Breast Cancer ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Metastasis

scholarly journals Correlation ER/PR status of Breast Carcinoma with Tumor size, Tumor grade, Lymphovascular emboli, Lymph node metastasis and the distant metastasis

2021 ◽  
Vol 6 (3) ◽  
pp. 191-196
Author(s):  
Vaibhav Mane ◽  
Nekta Anand ◽  
Darshana Wakkar
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Tumor Grade ◽  
Tumor Type ◽  
Receptor Status ◽  
Node Metastasis ◽  
Poor Predictor ◽  
Size Grade

Breast cancer is the most frequent cancer in females in the world and is the second most common cancer in India after cervical cancer. The breast cancer is second most common reason of loss of existence in each developed and additionally most of the growing countries. For the appraisal of prognosis of breast cancer commonly followed is the NOTTINGHAM PROGNOSTIC INDEX (NPI) which includes- tumor size, histological tumor grade, lymph node metastasis and hormone receptor status. These prognostic component help in administration and therapeutic requirement of breast cancer patient.1. To study the MRM specimens for size, grade of the tumor, LVI and LN metastases and the ER/PR receptors of the tumor. 2.To study the association of ER/PR status with the above mentioned prognostic parameters.This three-year study includes 50 histopathologically confirmed cases of carcinoma breast. The tumor type, grade, LNM, LVE were reported on H & E. The ER-PR study was done of all 50 cases. The tumor size, grade, NM, LVE were correlated with receptor status. Out of 50 cases majority (7.5%) of cases were in 41-50 years of age group, and tumor size was between 2-4 cm in (17.5%) cases; majority were of grade II carcinoma (17.5%) of which 13% were ER-PR positive. Out of 35 cases with negative LNM and LVE, 26 cases (13%) were ER-PR positive.In our observation there is no association between higher histological grade and ER-PR status. No obvious correlation with tumor size was noted. But increase in tumor size could also be a poor predictor of ER-PR status. LNM, LVE is poor predictor of ER-PR status.

Sign in / Sign up

Export Citation Format

Share Document