Good prediction of the likelihood for sentinel lymph node metastasis by using the MSKCC nomogram in a German breast cancer population.
BACKGROUND
The sentinel lymph node (SLN) procedure could be omitted in cases of accurate prediction of very high or very low probability of SLN metastasis in early breast cancer patients. We evaluated a breast cancer nomogram, an online tool provided by the Memorial Sloan-Kettering Cancer Center (MSKCC), that predicts the likelihood of a positive lymph node.


METHODS
Data from 545 patients with successful SLN biopsy were collected, including 118 patients with a positive sentinel lymph node. Histopathological assessment of the SLN included hematoxylin and eosin staining and/or immunohistochemistry. Predictive accuracy was assessed by calculating the area under the receiver-operator characteristic (ROC) curve.


RESULTS
In our collective tumor size, histology, lymphovascular infiltration, multifocality, Her-2-neu positivity, and nuclear grade correlated with the probability of SLN metastasis. The ROC of the validated nomogram in our breast cancer population revealed a value of 0.78 compared with 0.75 in the original publication.


CONCLUSIONS
The MSKCC nomogram is a useful tool in our population of breast cancer patients. However, variations in the pathological assessment of the SLN between breast cancer centers worldwide might be an impediment to widespread application of the nomogram.
Klar
M
M
Department of Obstetrics and Gynecology, University of Freiburg, Medical School, Freiburg, Germany. maximilian.klar@uniklinik-freiburg.de
Foeldi
M
M
Markert
S
S
Gitsch
G
G
Stickeler
E
E
Watermann
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D005858:Germany; D006801:Humans; D020407:Internet; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D049451:Nomograms; D021701:Sentinel Lymph Node Biopsy