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Erschienen in: Breast Cancer 5/2014

01.09.2014 | Original Article

Three models for predicting the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients

verfasst von: Tatsunari Sasada, Tsuyoshi Kataoka, Hideo Shigematsu, Norio Masumoto, Takayuki Kadoya, Morihito Okada, Hideki Ohdan

Erschienen in: Breast Cancer | Ausgabe 5/2014

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Abstract

Background

Axillary lymph node dissection (ALND) is the standard procedure for breast cancer with sentinel lymph node (SLN) metastasis. However, additional nodal metastasis is occasionally detected (<40 % cases) during complete ALND in patients with SLN metastasis. Several models have been developed to predict the non-SLN status of patients with SLN involvement. We evaluated 3 of these mathematical models independently.

Patients and Methods

A retrospective review was performed for 102 consecutive breast cancer patients with positive SLN biopsy who underwent ALND. We evaluated the area under the receiver operating characteristic curve (AUC) to determine the predicted risk of non-SLN metastases by using 3 mathematical models (from Memorial Sloan-Kettering Cancer Center (MSKCC), Stanford University, and Cambridge University).

Results

Of the 102 patients who underwent SLN biopsy, 47 (46.0 %) had a positive non-sentinel axillary lymph node metastasis. The AUC values were 0.71, 0.65, and 0.62 for the MSKCC, Stanford, and Cambridge nomograms, respectively.

Conclusions

None of the 3 nomograms had reasonable predictive power for the Japanese population. However, these nomograms can help individualize the surgical treatment of patients with positive SLN when the likelihood of further axillary metastasis is low. Each nomogram has its own characteristics for prediction of the risk of non-SLN metastasis.
Literatur
1.
Zurück zum Zitat Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.PubMedCrossRef Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.PubMedCrossRef
2.
Zurück zum Zitat Schwartz GF, Giuliano AE, Veronesi U. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, Pennsylvania. Cancer. 2002;94:2542–51. Schwartz GF, Giuliano AE, Veronesi U. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, Pennsylvania. Cancer. 2002;94:2542–51.
3.
Zurück zum Zitat Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997;349:1864–7.PubMedCrossRef Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997;349:1864–7.PubMedCrossRef
4.
Zurück zum Zitat Turner RR, Ollila DW, Krasne DL, Giuliano AE. Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg. 1997;226:271–6. (discussion 276–278).PubMedCentralPubMedCrossRef Turner RR, Ollila DW, Krasne DL, Giuliano AE. Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg. 1997;226:271–6. (discussion 276–278).PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Chu KU, Turner RR, Hansen NM, Brennan MB, Bilchik A, Giuliano AE. Do all patients with sentinel node metastasis from breast carcinoma need complete axillary node dissection? Ann Surg. 1999;229:536–41.PubMedCentralPubMedCrossRef Chu KU, Turner RR, Hansen NM, Brennan MB, Bilchik A, Giuliano AE. Do all patients with sentinel node metastasis from breast carcinoma need complete axillary node dissection? Ann Surg. 1999;229:536–41.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Kamath VJ, Giuliano R, Dauway EL, Cantor A, Berman C, Ku NN, et al. Characteristics of the sentinel lymph node in breast cancer predict further involvement of higher-echelon nodes in the axilla: a study to evaluate the need for complete axillary lymph node dissection. Arch Surg. 2001;136:688–92.PubMedCrossRef Kamath VJ, Giuliano R, Dauway EL, Cantor A, Berman C, Ku NN, et al. Characteristics of the sentinel lymph node in breast cancer predict further involvement of higher-echelon nodes in the axilla: a study to evaluate the need for complete axillary lymph node dissection. Arch Surg. 2001;136:688–92.PubMedCrossRef
7.
Zurück zum Zitat Turner RR, Chu KU, Qi K, Botnick LE, Hansen NM, Glass EC, et al. Pathologic features associated with nonsentinel lymph node metastases in patients with metastatic breast carcinoma in a sentinel lymph node. Cancer. 2000;89:574–81.PubMedCrossRef Turner RR, Chu KU, Qi K, Botnick LE, Hansen NM, Glass EC, et al. Pathologic features associated with nonsentinel lymph node metastases in patients with metastatic breast carcinoma in a sentinel lymph node. Cancer. 2000;89:574–81.PubMedCrossRef
8.
Zurück zum Zitat Reynolds C, Mick R, Donohue JH, Grant CS, Farley DR, Callans LS, et al. Sentinel lymph node biopsy with metastasis: can axillary dissection be avoided in some patients with breast cancer? J Clin Oncol. 1999;17:1720–6.PubMed Reynolds C, Mick R, Donohue JH, Grant CS, Farley DR, Callans LS, et al. Sentinel lymph node biopsy with metastasis: can axillary dissection be avoided in some patients with breast cancer? J Clin Oncol. 1999;17:1720–6.PubMed
9.
Zurück zum Zitat Jinno H, Sakata M, Asaga S, Wada M, Shimada T, Kitagawa Y, et al. Predictors to assess non-sentinel lymph node status in breast cancer patients with sentinel lymph node metastasis. Breast J. 2008;14:551–5.PubMedCrossRef Jinno H, Sakata M, Asaga S, Wada M, Shimada T, Kitagawa Y, et al. Predictors to assess non-sentinel lymph node status in breast cancer patients with sentinel lymph node metastasis. Breast J. 2008;14:551–5.PubMedCrossRef
10.
Zurück zum Zitat Viale G, Maiorano E, Pruneri G, Mastropasqua MG, Valentini S, Galimberti V, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241:319–25.PubMedCentralPubMedCrossRef Viale G, Maiorano E, Pruneri G, Mastropasqua MG, Valentini S, Galimberti V, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241:319–25.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Pal A, Provenzano E, Duffy SW, Pinder SE, Purushotham AD. A model for predicting non-sentinel lymph node metastatic disease when the sentinel lymph node is positive. Br J Surg. 2008;95:302–9.PubMedCrossRef Pal A, Provenzano E, Duffy SW, Pinder SE, Purushotham AD. A model for predicting non-sentinel lymph node metastatic disease when the sentinel lymph node is positive. Br J Surg. 2008;95:302–9.PubMedCrossRef
12.
Zurück zum Zitat Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.PubMedCrossRef Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.PubMedCrossRef
13.
Zurück zum Zitat Yi M, Giordano SH, Meric-Bernstam F, Mittendorf EA, Kuerer HM, Hwang RF, et al. Trends in and outcomes from sentinel lymph node biopsy (SLNB) alone vs. SLNB with axillary lymph node dissection for node-positive breast cancer patients: experience from the SEER database. Ann Surg Oncol. 2010;17(Suppl 3):343–51.PubMedCrossRef Yi M, Giordano SH, Meric-Bernstam F, Mittendorf EA, Kuerer HM, Hwang RF, et al. Trends in and outcomes from sentinel lymph node biopsy (SLNB) alone vs. SLNB with axillary lymph node dissection for node-positive breast cancer patients: experience from the SEER database. Ann Surg Oncol. 2010;17(Suppl 3):343–51.PubMedCrossRef
14.
Zurück zum Zitat Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23:4312–21.PubMedCrossRef Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23:4312–21.PubMedCrossRef
15.
Zurück zum Zitat Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88:608–14.PubMedCrossRef Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88:608–14.PubMedCrossRef
16.
Zurück zum Zitat Van Zee KJ, Manasseh DM, Bevilacqua JL, Boolbol SK, Fey JV, Tan LK, et al. A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Ann Surg Oncol. 2003;10:1140–51.PubMedCrossRef Van Zee KJ, Manasseh DM, Bevilacqua JL, Boolbol SK, Fey JV, Tan LK, et al. A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Ann Surg Oncol. 2003;10:1140–51.PubMedCrossRef
17.
Zurück zum Zitat Kohrt HE, Olshen RA, Bermas HR, Goodson W H, Wood DJ, Henry S, et al. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients. BMC Cancer. 2008;8–66. Kohrt HE, Olshen RA, Bermas HR, Goodson W H, Wood DJ, Henry S, et al. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients. BMC Cancer. 2008;8–66.
18.
Zurück zum Zitat Akobeng AK. Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr. 2007;96:644–7.PubMedCrossRef Akobeng AK. Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr. 2007;96:644–7.PubMedCrossRef
19.
Zurück zum Zitat Fan J, Upadhye S, Worster A. Understanding receiver operating characteristic (ROC) curves. CJEM. 2006;8:19–20.PubMed Fan J, Upadhye S, Worster A. Understanding receiver operating characteristic (ROC) curves. CJEM. 2006;8:19–20.PubMed
20.
Zurück zum Zitat Moghaddam Y, Falzon M, Fulford L, Williams NR, Keshtgar MR. Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer. Br J Surg. 2010;97:1646–52.PubMedCrossRef Moghaddam Y, Falzon M, Fulford L, Williams NR, Keshtgar MR. Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer. Br J Surg. 2010;97:1646–52.PubMedCrossRef
Metadaten
Titel
Three models for predicting the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients
verfasst von
Tatsunari Sasada
Tsuyoshi Kataoka
Hideo Shigematsu
Norio Masumoto
Takayuki Kadoya
Morihito Okada
Hideki Ohdan
Publikationsdatum
01.09.2014
Verlag
Springer Japan
Erschienen in
Breast Cancer / Ausgabe 5/2014
Print ISSN: 1340-6868
Elektronische ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-012-0435-1

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