Abstract PD06-08: Size Matters: Incorporation of Sentinel Lymph Node (SLN) Metastasis Size into a Nomogram Predicting NonSLN Involvement in SLN Positive Breast Cancer Patients

Autor: Anthony Lucci, Isabelle Bedrosian, Amy C. Degnim, Gildy Babiera, H. M. Kuerer, M. I. Ross, Elizabeth A. Mittendorf, Min Yi, Funda Meric-Bernstam, Roland L. Bassett, Judy C. Boughey, R Harrell, Rf. Hwang, K. K. Hunt
Rok vydání: 2010
Předmět:
Zdroj: Cancer Research. 70:PD06-08
ISSN: 1538-7445
0008-5472
DOI: 10.1158/0008-5472.sabcs10-pd06-08
Popis: Purpose: Emerging data from cooperative group trials suggests that not all patients with a positive SLN require completion axillary lymph node dissection (ALND). The controversy regarding who will benefit from additional nodal clearance continues, suggesting a need for improved tools to predict non-SLN involvement. We hypothesized that the size of a SLN metastasis evaluated as a continuous variable would be an important predictor of non-SLN involvement. The goal of this study was to determine clinicopathologic factors including SLN metastasis size that predicted non-SLN involvement and to use these factors to construct an improved predictive nomogram. Methods: Using a prospective database, we identified 509 patients with invasive breast cancer from 1996 - 2007 with a positive SLN who underwent ALND. Patients receiving neoadjuvant therapy were excluded. Clinicopathologic data including age, primary tumor size, presence of multifocal disease, histology (invasive ductal vs. invasive lobular vs. mixed invasive), tumor grade, estrogen receptor, progesterone receptor, and HER2/neu status, presence of lymphovascular invasion (LVI), the number of SLNs identified, number of positive SLNs, the maximum SLN metastasis size and the presence of extranodal extension were recorded. For SLNs described only as containing isolated tumor cells, size was recorded as 0.1 mm. Univariate and multivariate logistic regression analyses were performed to identify factors predictive of positive non-SLNs. Using these variables, a nomogram was constructed and subsequently validated using an external cohort of 464 patients. Results: On univariate analysis, the following factors were predictive of positive non-SLNs: number of SLN identified (p Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD06-08.
Databáze: OpenAIRE
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