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Good Prediction of the Likelihood for Sentinel Lymph Node Metastasis by Using the MSKCC Nomogram in a German Breast Cancer Population

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The sentinel lymph node (SLN) procedure could be omitted in cases of accurate prediction of very high or very low probability of SLN metastasis in early breast cancer patients. We evaluated a breast cancer nomogram, an online tool provided by the Memorial Sloan–Kettering Cancer Center (MSKCC), that predicts the likelihood of a positive lymph node.

Methods

Data from 545 patients with successful SLN biopsy were collected, including 118 patients with a positive sentinel lymph node. Histopathological assessment of the SLN included hematoxylin and eosin staining and/or immunohistochemistry. Predictive accuracy was assessed by calculating the area under the receiver–operator characteristic (ROC) curve.

Results

In our collective tumor size, histology, lymphovascular infiltration, multifocality, Her-2-neu positivity, and nuclear grade correlated with the probability of SLN metastasis. The ROC of the validated nomogram in our breast cancer population revealed a value of 0.78 compared with 0.75 in the original publication.

Conclusion

The MSKCC nomogram is a useful tool in our population of breast cancer patients. However, variations in the pathological assessment of the SLN between breast cancer centers worldwide might be an impediment to widespread application of the nomogram.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Freiburg, Medical School, Freiburg, Germany

    M. Klar MD, M. Foeldi MD, S. Markert MD, G. Gitsch MD, E. Stickeler MD & D. Watermann MD

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  1. M. Klar MD
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  2. M. Foeldi MD
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  3. S. Markert MD
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  4. G. Gitsch MD
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  5. E. Stickeler MD
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  6. D. Watermann MD
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Correspondence to M. Klar MD.

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Klar, M., Foeldi, M., Markert, S. et al. Good Prediction of the Likelihood for Sentinel Lymph Node Metastasis by Using the MSKCC Nomogram in a German Breast Cancer Population. Ann Surg Oncol 16, 1136–1142 (2009). https://doi.org/10.1245/s10434-009-0399-3

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  • DOI: https://doi.org/10.1245/s10434-009-0399-3

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