USEFULNESS AND PREDICTIVE POWER OF MEMORIAL SLOAN-KETTERING CANCER CENTER NOMOGRAM IN NON-SENTINEL LYMPH NODE METASTASES OUT OF SENTINEL LYMPH NODE METASTASED BREAST CANCER PATIENTS

Abstract

Purpose: In breast carcinoma, axillary metastasis is the leading prognostic factor. While axillary dissection (AD) is performed in patients with sentinel lymph node (SLN) involvement, there are patients without non-sentinel lymph node (non-SLN) involvement. To defi ne the predicting power and availability of the nomogram, this has been developed in Memorial Sloan-Kettering Cancer Center by Zee et al, in non-SLN involved patients among breast cancer patients with SLN involvement.Patients and Methods: The variables used in Memorial Sloan-Kettering Cancer Center nomogram (pathologic size, type, nuclear grade, lymphovascular invasion, multifocality, estrogen receptor positivity of the tumor, defi ning methods of SLN metastases, positive and negative SLN numbers) are evaluated. The predicted values are compared with the real non-SLN metastases.Results: While there was no SLN metastases in seventeen patients (45.94%) out of 37, the remaining 20 patients (54.05%) were observed to have non-SLN involvement. When the nomogram is applied, statistically signifi cant involvement was observed in over 70% of patients with non-SLN involvement probability (p=0.022).Discussion: This nomogram can help to predict the non-SLN metastases in breast carcinoma patients. However, it is not adequate to inform patients about non-performance of AD preoperatively. New studies are required to abstain from AD due to non-SLN involvement by preoperative data.

Keywords

• breast carcinoma
• axillary lymph node
• sentinel lymph node