Nonsentinel node metastasis in breast cancer patients: assessment of an existing and a new predictive nomogram.
BACKGROUND
The accurate prediction of nonsentinel node (NSN) metastasis in breast cancer patients remains uncertain.


METHODS
The medical records of 574 breast cancer patients from 2 different institutions (Mayo Clinic and University of Michigan) with sentinel lymph node biopsy examination and completion axillary lymph node dissection were reviewed for multiple clinicopathologic variables. The Memorial Sloan Kettering Cancer Center nomogram performance for prediction of NSN metastases was assessed. A new model was developed with clinically relevant variables and possible advantages.


RESULTS
The Memorial Sloan Kettering Cancer Center nomogram predicted the likelihood of NSN metastasis with an area under the receiver operating characteristic curve of .72 and .86. For predicted probability cut-off points of 5% and 10%, the false-negative rates were 0% and 14% (Mayo), and 17% and 11% (Michigan). A new model was developed with similar area under the curve but lower false-negative rates for low-probability subgroups.


CONCLUSIONS
Predictive models for NSN tumor burden are imperfect.
Degnim
Amy C
AC
Department of Surgery, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA. Degnim.Amy@mayo.edu
Reynolds
Carol
C
Pantvaidya
Gouri
G
Zakaria
Shaheen
S
Hoskin
Tanya
T
Barnes
Sunni
S
Roberts
Margaret V
MV
Lucas
Peter C
PC
Oh
Kevin
K
Koker
Meryem
M
Sabel
Michael S
MS
Newman
Lisa A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D008954:Models, Biological; D049451:Nomograms; D011237:Predictive Value of Tests