title: Three models for predicting the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients.
abstract: BACKGROUND
  Axillary lymph node dissection (ALND) is the standard procedure for breast cancer with sentinel lymph node (SLN) metastasis. However, additional nodal metastasis is occasionally detected (<40 % cases) during complete ALND in patients with SLN metastasis. Several models have been developed to predict the non-SLN status of patients with SLN involvement. We evaluated 3 of these mathematical models independently.
  
  
  METHODS
  A retrospective review was performed for 102 consecutive breast cancer patients with positive SLN biopsy who underwent ALND. We evaluated the area under the receiver operating characteristic curve (AUC) to determine the predicted risk of non-SLN metastases by using 3 mathematical models (from Memorial Sloan-Kettering Cancer Center (MSKCC), Stanford University, and Cambridge University).
  
  
  RESULTS
  Of the 102 patients who underwent SLN biopsy, 47 (46.0 %) had a positive non-sentinel axillary lymph node metastasis. The AUC values were 0.71, 0.65, and 0.62 for the MSKCC, Stanford, and Cambridge nomograms, respectively.
  
  
  CONCLUSIONS
  None of the 3 nomograms had reasonable predictive power for the Japanese population. However, these nomograms can help individualize the surgical treatment of patients with positive SLN when the likelihood of further axillary metastasis is low. Each nomogram has its own characteristics for prediction of the risk of non-SLN metastasis.
authors: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima, 734-8551, Japan, ssthky@gmail.com.
authors: Tatsunari
authors: T
authors: Sasada
authors: Tsuyoshi
authors: T
authors: Kataoka
authors: Hideo
authors: H
authors: Shigematsu
authors: Norio
authors: N
authors: Masumoto
authors: Takayuki
authors: T
authors: Kadoya
authors: Morihito
authors: M
authors: Okada
authors: Hideki
authors: H
authors: Ohdan
mesh_terms: D019540:Area Under Curve; D044466:Asian People; D001365:Axilla / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D008962:Models, Theoretical; D049451:Nomograms; D012372:ROC Curve; D021701:Sentinel Lymph Node Biopsy