Can the Memorial Sloan-Kettering Cancer Center nomogram predict the likelihood of nonsentinel lymph node metastases in breast cancer patients in The Netherlands? Journal Article


Authors: Smidt, M. L.; Kuster, D. M.; Van Der Wilt, G. J.; Thunnissen, F. B.; Van Zee, K. J.; Strobbe, L. J. A.
Article Title: Can the Memorial Sloan-Kettering Cancer Center nomogram predict the likelihood of nonsentinel lymph node metastases in breast cancer patients in The Netherlands?
Abstract: Background: According to Dutch guidelines, an axillary lymph node dissection (ALND) is recommended whenever a sentinel lymph node (SLN) contains metastatic disease. However, only in approximately 50% of patients with metastatic disease in the SLN are additional nodal metastases detected in the completion ALND. To identify the individual patient's risk for non-SLN metastases, a nomogram containing eight predictors was developed by the Breast Service of Memorial Sloan-Kettering Cancer Center (New York, NY). The aim of this study was to test the accuracy of the nomogram on a population of Dutch breast cancer patients. Methods: Patient, tumor, and SLN metastasis characteristics were collected for 222 consecutive patients who underwent a completion ALND. The data of the index and test populations were compared. A receiver operating characteristic curve was drawn, and the area under the curve was calculated to assess the discriminative power of the nomogram. Results: Even though our patient population differed in many respects from the source population, the area under the receiver operating characteristic curve amounted to .77, a value very much comparable to the one found in the source population. Conclusions: The nomogram provides a fairly accurate predicted probability for the likelihood of non-SLN metastases in a general population of breast cancer patients at a regional teaching hospital in The Netherlands. This suggests that the nomogram's originally calculated predictive accuracy may be valid for patient populations that differ considerably from the population in which it was developed. © 2005 The Society of Surgical Oncology, Inc.
Keywords: adult; controlled study; aged; middle aged; major clinical study; area under the curve; lymph node metastasis; lymph node dissection; lymphatic metastasis; lymph node excision; sentinel lymph node biopsy; accuracy; breast cancer; breast neoplasms; prediction; risk assessment; netherlands; axillary lymph node; nomograms; predictive value of tests; nomogram; roc curve; receiver operating characteristic; calculation; paraffin embedding; likelihood functions; axillary metastases
Journal Title: Annals of Surgical Oncology
Volume: 12
Issue: 12
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2005-12-01
Start Page: 1066
End Page: 1072
Language: English
DOI: 10.1245/aso.2005.07.022
PUBMED: 16244802
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 64" - "Export Date: 24 October 2012" - "CODEN: ASONF" - "Source: Scopus"
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  1. Kimberly J Van Zee
    280 Van Zee