International Journal of Radiation Oncology * Biology * Physics
Volume 75, Issue 4 , Pages 1035-1040 , 15 November 2009

Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

  • Bulent Unal, M.D.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Akif Serhat Gur, M.D.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Sushil Beriwal, M.D.

      Affiliations

    • Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Gong Tang, Ph.D.

      Affiliations

    • Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
    • ,
  • Ronald Johnson, M.D.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Gretchen Ahrendt, M.D.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Marguerite Bonaventura, M.D.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • ,
  • Atilla Soran, M.D., M.P.H.

      Affiliations

    • Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
    • Corresponding Author InformationReprint requests to: Atilla Soran, M.D., M.P.H., F.A.C.S., Department of Surgical Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, 300 Halket St., Suite 2601, Pittsburgh, PA. Tel: (412) 641-1316; Fax: (412) 641-1446

Received 2 October 2008 ,Revised 10 December 2008 ,Accepted 11 December 2008.

References 

  1. Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989;63:181–187
  2. Beriwal S, Soran A, Kocer B, et al. Factors that predict the burden of axillary disease in breast cancer patients with a positive sentinel node. Am J Clin Oncol. 2008;31:34–38
  3. Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–7720
  4. Van Zee KJ, Manasseh DM, Bevilacqua JL, 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;10:1140–1151
  5. Barranger E, Coutant C, Flahault A, et al. An axilla scoring system to predict non-sentinel lymph node status in breast cancer patients with sentinel lymph node involvement. Breast Cancer Res Treat. 2005;91:113–119
  6. Pal A, Provenzano E, Duffy SW, et al. A model for predicting non-sentinel lymph node metastatic disease when the sentinel lymph node is positive. Br J Surg. 2008;95:302–309
  7. Kohrt HE, Olshen RA, Bermas HR, 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
  8. Recht A, Gray R, Davidson NE, et al. Locoregional failure 10 years after mastectomy and adjuvant chemotherapy with or without tamoxifen without irradiation: Experience of the Eastern Cooperative Oncology Group. J Clin Oncol. 1999;17:1689–1700
  9. Recht A, Pierce SM, Abner A, et al. Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol. 1991;9:988–996
  10. Galper S, Recht A, Silver B, et al. Factors associated with regional nodal failure in patients with early stage breast cancer with 0–3 positive axillary nodes following tangential irradiation alone. Int J Radiat Oncol Biol Phys. 1999;45:1157–1166
  11. Halverson KJ, Taylor ME, Perez CA, et al. Regional nodal management and patterns of failure following conservative surgery and radiation therapy for stage I and II breast cancer. Int J Radiat Oncol Biol Phys. 1993;26:593–599
  12. Grills IS, Kestin LL, Goldstein N, et al. Risk factors for regional nodal failure after breast-conserving therapy: Regional nodal irradiation reduces rate of axillary failure in patients with four or more positive lymph nodes. Int J Radiat Oncol Biol Phys. 2003;56:658–670
  13. Katz A, Smith BL, Golshan M, et al. Nomogram for the prediction of having four or more involved nodes for sentinel lymph node-positive breast cancer. J Clin Oncol. 2008;26:2093–2098
  14. Sobin LH, Wittekind CH International Union Against Cancer (IUCC). TNM classification of malignant tumors. 6th ed.. New York: Wiley-Liss; 2002;
  15. Klar M, Jochmann A, Foeldi M, et al. The MSKCC nomogram for prediction the likelihood of non-sentinel node involvement in a German breast cancer population. Breast Cancer Res Treat. 2008;112:523–531
  16. Shahar KH, Hunt KK, Thames HD, et al. Factors predictive of having four or more positive axillary lymph nodes in patients with positive sentinel lymph nodes: Implications for selection of radiation fields. Int J Radiat Oncol Biol Phys. 2004;59:1074–1079
  17. Sachdev U, Murphy K, Derzie A, et al. Predictors of non-sentinel lymph node metastasis in breast cancer patients. Am J Surg. 2002;183:213–217
  18. Reynolds C, Mick R, Donohue JH, et al. Sentinel lymph node biopsy with metastasis: Can axillary dissection be avoided in some patients in breast cancer?. J Clin Oncol. 1999;17:1720–1726
  19. Weiser MR, Montgomery LL, Tan LK, et al. Lymphovascular invasion enhances the prediction of non-sentinel node metastases in breast cancer patients with positive sentinel nodes. Ann Surg Oncol. 2001;8:145–149
  20. Wong SL, Edwards MJ, Chao C, et al. Predicting the status of the nonsentinel axillary nodes: A multicenter study. Arch Surg. 2001;136:563–568
  21. Rahusen FD, Torrenga H, van Diest PJ, et al. Predictive factors for metastatic involvement of nonsentinel nodes in patients with breast cancer. Arch Surg. 2001;136:1059–1063
  22. Degnim AC, Reynolds C, Pantvaidya G, et al. Nonsentinel node metastasis in breast cancer patients: Assessment of an existing and a new predictive nomogram. Am J Surg. 2005;190:543–550

 Accepted as a poster presentation at San Antonio Breast Cancer Symposium 2008.

 Conflict of interest: none.

PII: S0360-3016(08)03926-6

doi: 10.1016/j.ijrobp.2008.12.028

International Journal of Radiation Oncology * Biology * Physics
Volume 75, Issue 4 , Pages 1035-1040 , 15 November 2009

Article Tools

* Image Usage & Resolution