Multi-institutional comparison of non-sentinel lymph node predictive tools in breast cancer patients with high predicted risk of further axillary metastasis

G. Cserni, R. Bori, Róbert Maráz, Marjut H K Leidenius, Tuomo J. Meretoja, Paivi S. Heikkila, Peter Regitnig, Gero Luschin-Ebengreuth, Janez Zgajnar, Andraz Perhavec, Barbara Gazic, G. Lazar, Tibor Takács, András Vörös, Riccardo A. Audisio

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Although axillary lymph node dissection (ALND) has been the standard intervention in breast cancer patients with sentinel lymph node (SLN) metastasis, only a small proportion of patients benefit from this operation, because most do not harbor additional metastases in the axilla. Several predictive tools have been constructed to identify patients with low risk of non-SLN metastasis who could be candidates for the omission of ALND. In the present work, predictive nomograms were used to predict a high (>50 %) risk of non-SLN metastasis in order to identify patients who would most probably benefit from further axillary treatment. Data of 1000 breast cancer patients with SLN metastasis and completion ALND from 5 institutions were tested in 4 nomograms. A subset of 313 patients with micrometastatic SLNs were also tested in 3 different nomograms devised for the micrometastatic population (the high risk cut-off being 20 %). Patients with a high predicted risk of non-SLN metastasis had higher rates of metastasis in the non-SLNs than patients with low predicted risk. The positive predictive values of the nomograms ranged from 44 % to 64 % with relevant inter-institutional variability. The nomograms for micrometastatic SLNs performed much better in identifying patients with low risk of non-SLN involvement than in high-risk-patients; for the latter, the positive predictive values ranged from 13 % to 20 %. The nomograms show inter-institutional differences in their predictive values and behave differently in different settings. They are worse in identifying high risk patients than low-risk ones, creating a need for new predictive models to identify high-risk patients.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalPathology and Oncology Research
Volume19
Issue number1
DOIs
Publication statusPublished - Jan 2013

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Lymph Nodes
Breast Neoplasms
Neoplasm Metastasis
Nomograms
Lymph Node Excision
Axilla
Population

Keywords

  • Axillary lymph node dissection
  • Breast cancer
  • High risk
  • Nomogram
  • Non-sentinel lymph node
  • Sentinel lymph node

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pathology and Forensic Medicine

Cite this

Multi-institutional comparison of non-sentinel lymph node predictive tools in breast cancer patients with high predicted risk of further axillary metastasis. / Cserni, G.; Bori, R.; Maráz, Róbert; Leidenius, Marjut H K; Meretoja, Tuomo J.; Heikkila, Paivi S.; Regitnig, Peter; Luschin-Ebengreuth, Gero; Zgajnar, Janez; Perhavec, Andraz; Gazic, Barbara; Lazar, G.; Takács, Tibor; Vörös, András; Audisio, Riccardo A.

In: Pathology and Oncology Research, Vol. 19, No. 1, 01.2013, p. 95-101.

Research output: Contribution to journalArticle

Cserni, G, Bori, R, Maráz, R, Leidenius, MHK, Meretoja, TJ, Heikkila, PS, Regitnig, P, Luschin-Ebengreuth, G, Zgajnar, J, Perhavec, A, Gazic, B, Lazar, G, Takács, T, Vörös, A & Audisio, RA 2013, 'Multi-institutional comparison of non-sentinel lymph node predictive tools in breast cancer patients with high predicted risk of further axillary metastasis', Pathology and Oncology Research, vol. 19, no. 1, pp. 95-101. https://doi.org/10.1007/s12253-012-9553-5
Cserni, G. ; Bori, R. ; Maráz, Róbert ; Leidenius, Marjut H K ; Meretoja, Tuomo J. ; Heikkila, Paivi S. ; Regitnig, Peter ; Luschin-Ebengreuth, Gero ; Zgajnar, Janez ; Perhavec, Andraz ; Gazic, Barbara ; Lazar, G. ; Takács, Tibor ; Vörös, András ; Audisio, Riccardo A. / Multi-institutional comparison of non-sentinel lymph node predictive tools in breast cancer patients with high predicted risk of further axillary metastasis. In: Pathology and Oncology Research. 2013 ; Vol. 19, No. 1. pp. 95-101.
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