title: Validation of three breast cancer nomograms and a new formula for predicting non-sentinel lymph node status.
abstract: BACKGROUND
  The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population.
  
  
  METHODS
  We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram.
  
  
  RESULTS
  After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814.
  
  
  CONCLUSIONS
  The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.
authors: Akcaabat State Hospital, Trabzon, Turkey. serhanderici@gmail.com
authors: Serhan
authors: S
authors: Derici
authors: Ali
authors: A
authors: Sevinc
authors: Omer
authors: O
authors: Harmancioglu
authors: Serdar
authors: S
authors: Saydam
authors: Mehmet
authors: M
authors: Kocdor
authors: Suleyman
authors: S
authors: Aksoy
authors: Tufan
authors: T
authors: Egeli
authors: Tulay
authors: T
authors: Canda
authors: Hulya
authors: H
authors: Ellidokuz
authors: Solen
authors: S
authors: Derici
mesh_terms: D001943:Breast Neoplasms; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D049451:Nomograms; D021701:Sentinel Lymph Node Biopsy