A head to head comparison of nine tools predicting non-sentinel lymph node status in sentinel node positive breast cancer women

I. van den Hoven, G. Kuijt, R. Roumen, A. Voogd, E.W. Steyerberg, Y. Vergouwe

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and objectivesThis study was conducted to evaluate the performance of available tools predicting non-sentinel lymph node (non-SLN) status in women with SLN positive breast cancer and to see if they can be safely used in everyday clinical practice.

MethodsData of 220 women with breast cancer who underwent a SLN biopsy at the Maxima Medical Centre between 2000-2008 were analysed. Tools evaluated were: the models from Memorial Sloan Kettering Cancer Centre, Stanford, Mayo, Cambridge, Gur, and MOU, and the scores from Saidi, Tenon, and MDA. Model performance was assessed using calibration, discrimination and Nagelkerke's explained variation.

ResultsThe MSKCC nomogram showed best overall performance with best discrimination (AUC 0.69), second best calibration, and highest explained variation (31%). The 10% low risk threshold led to defining only 22% (38/176) of the women as being low risk while in fact 66% (116/176) were non-SLN negative. The false negative rate was 13% (5/38).

ConclusionsCurrent models for predicting non-SLN metastases in SLN positive breast cancer are not yet ready for implementation in general practice. Further research efforts should improve model performance in selecting patients or perhaps find a role in support in the paradigm shift to a treat none unless approach. J. Surg. Oncol. 2015 111:133-138. (c) 2015 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)133-138
Number of pages6
JournalJournal of Surgical Oncology
Volume112
Issue number2
DOIs
Publication statusPublished - 1 Aug 2015

Keywords

  • sentinel lymph node biopsy
  • axillary lymph node dissection
  • nomogram
  • predictive system
  • breast cancer
  • CENTER NOMOGRAM
  • MSKCC NOMOGRAM
  • BIOPSY
  • METASTASES
  • INVOLVEMENT
  • LIKELIHOOD
  • MULTICENTER
  • MODELS
  • TRIAL
  • VALIDATION

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