Nomograms for preoperative prediction of axillary nodal status in breast cancer. BJS 2017; 104: 1494-1505.
Published: 18th July 2017
Authors: L. Dihge, P.‐O. Bendahl, L. Rydén
Axillary staging in patients with breast cancer and clinically node‐negative disease is performed by sentinel node biopsy (
Patients presenting to Skåne University Hospital, Lund, with breast cancer were included in a prospectively maintained registry between January 2009 and December 2012. Those with a preoperative diagnosis of nodal metastases were excluded. Patients with data on hormone receptor status, human epidermal growth factor receptor 2 and Ki‐67 expression were included to allow grouping into surrogate molecular subtypes. Based on logistic regression analyses, nomograms summarizing the strength of the associations between the predictors and each nodal status endpoint were developed. Predictive performance was assessed using the area under the receiver operating characteristic (
Of the 692 patients eligible for analysis, 248 were diagnosed with node‐positive disease. Molecular subtype, age, mode of detection, tumour size, multifocality and vascular invasion were identified as predictors of any nodal disease. Nomograms that included these predictors demonstrated good predictive abilities, and comparable performances in the internal validation; the area under the
The nomograms presented facilitate preoperative decision‐making regarding the extent of axillary surgery.Full text
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