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Annals of Surgical Oncology

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01-06-2012 | Breast Oncology

High Intersystem Variability for the Prediction of Additional Axillary Non-Sentinel Lymph Node Involvement in Individual Patients with Sentinel Node-Positive Breast Cancer

Authors: Ingrid van den Hoven, MD, Gerrit P. Kuijt, MD, Adri C. Voogd, PhD, Rudi M. H. Roumen, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2012

Abstract

Purpose

To compare the outcomes of the available systems that predict the risk of non-sentinel lymph node (non-SLN) metastasis and to evaluate the variability within a group of SLN-positive breast cancer patients.

Methods

Predicted probabilities and scores for non-SLN metastasis were calculated with nine predictive systems for 120 SLN-positive patients who underwent a completion axillary lymph node dissection. The number of patients was calculated that were considered low risk or had a probability of ≤10% by at least one of the systems. For each nomogram, a box plot was constructed. All patients with a predicted probability of ≤10% according to the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram were selected, and a comparison was made with the probabilities predicted by the other systems.

Results

Nearly two-thirds (64.2%, n = 77) of patients with SLN-positive breast cancer were allocated to a low-risk or low-probability group by at least one of the predictive systems. No patients were uniformly classified as low risk by all nine prediction models. At the group level, a considerable variation in the distribution of the predicted probabilities was observed. At the individual level, calculation of the predicted probabilities for the selected patients who were considered low risk (≤10%) according to the MSKCC nomogram, showed even larger variations, ranging from 4 to 94%.

Conclusions

This study shows that there is an unacceptably high variability in individual predictions when the predictive systems that are currently available are used to predict non-SLN metastasis in patients with SLN-positive breast cancer.

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Title: High Intersystem Variability for the Prediction of Additional Axillary Non-Sentinel Lymph Node Involvement in Individual Patients with Sentinel Node-Positive Breast Cancer
Authors: Ingrid van den Hoven, MD
Gerrit P. Kuijt, MD
Adri C. Voogd, PhD
Rudi M. H. Roumen, MD, PhD
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 6/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-2169-2

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Springer Medicine

High Intersystem Variability for the Prediction of Additional Axillary Non-Sentinel Lymph Node Involvement in Individual Patients with Sentinel Node-Positive Breast Cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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