title: [Risk factors of non-sentinel lymph node metastasis and performance of MSKCC nomogramin breast cancer patients with metastatic sentinel lymph node].
abstract: OBJECTIVE
  To study the factors influencing the non-sentinel lymph node(NSLN) status and to assess performance of Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram in predicting sentinel lymph node(SLN) metastases in a SLN positive Chinese breast cancer population.
  
  
  METHODS
  Data were collected from breast cancer patients who were diagnosed with pathological positive sentinel lymph node and received further axillary lymph node dissection(ALND) in Shanghai Ruijin Hospital from January 2011 to August 2014. MSKCC nomogram was used to calculate each patient's NSLN metastasis risk score. The receiver operator characteristic curve (ROC curve) and the area under the ROC curve (AUC) was used to assess the predictive accuracy of the model.
  
  
  RESULTS
  Among the 1 147 patients who received sentinel biopsy, 150 SLN positive patients who received ALND were enrolled in this study. By univariate analysis, multifocal breast cancer (χ(2)=5.887, P=0.015), SLN+ /SLN ratio (χ(2)=6.683, P=0.010) and abnormal axillary lymph node displayed by ultrasound (χ(2)=7.736, P=0.005) were the influencing factors of NSLN metastases. By multivariate analysis, multifocal breast cancer (OR=7.25, 95% CI: 1.73 to 30.43, P=0.007), SLN+ /SLN ratio ≥ 0.5 (OR=2.564, 95% CI: 1.22 to 5.39, P=0.013) and abnormal axillary lymph node displayed by ultrasound (OR=2.471, 95% CI: 1.18 to 5.19, P=0.017) were the independent influencing factors of NSLN metastases. The AUC of MSKCC nomogram in this population was 0.677.
  
  
  CONCLUSIONS
  For breast cancer patients with positive sentinel lymph node, multifocality, SLN+ /SLN ratio and axillary lymphadenopathy displayed by ultrasound is related to NSLN metastasis. MSKCC has low accuracy in predicting NSLN status of this population.
authors: Comprehensive Breast Health Center, Shanghai Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors: Jiahui
authors: J
authors: Huang
authors: Xiaosong
authors: X
authors: Chen
authors: Xiaochun
authors: X
authors: Fei
authors: Ou
authors: O
authors: Huang
authors: Jiayi
authors: J
authors: Wu
authors: Yu
authors: Y
authors: Zong
authors: Li
authors: L
authors: Zhu
authors: Jianrong
authors: J
authors: He
authors: Weiguo
authors: W
authors: Chen
authors: Yafen
authors: Y
authors: Li
authors: Email: kwshen@medmail.com.cn.
authors: Kunwei
authors: K
authors: Shen
mesh_terms: D019540:Area Under Curve; D001365:Axilla; D001943:Breast Neoplasms; D002681:China; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D015999:Multivariate Analysis; D049451:Nomograms; D012372:ROC Curve; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy