The effect of sentinel lymph node biopsy on the Nottingham Prognostic Index in breast cancer patients.
The Nottingham Prognostic Index (NPI) is a prognostic variable suitable for the stratification of breast cancer patients for adjuvant systemic treatment. The impact of sentinel node biopsy (SNB) and of the assessment of nodal involvement was evaluated in 136 successful SNB procedures completed by axillary dissection (AD). The three strategies assessed included SNB and AD in all cases, AD only in SN-positive cases, and AD only if the SN contained macrometastases. Isolated tumour cells in lymph nodes were regarded either as metastases or as negative findings. The success rate and accuracy of SNB were 90% and 96%, respectively. The NPI was influenced by variations in the surgical staging strategy and the definition of nodal involvement, in at most, five patients. Adjuvant systemic treatment, indicated on the basis of the NPI is less influenced by staging strategies and definitions of metastases than that given on the basis of nodal status alone.
Cserni
G
G
Bács-Kiskun County Teaching Hospital, Department of Pathology, Kecskemét, Hungary. cserni@freemail.c3.hu
D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D016019:Survival Analysis