Predictive Factors for Sentinel Lymph Node Metastasis and Validation of Memorial Sloan–Kettering Cancer Center Nomogram in Thai Breast Cancer Patients

Predictive Factors for Sentinel Node Metastasis

Authors

  • Anongporn Nimboriboonporn Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Doonyapat Sa-nguanraksa Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Norasate Samarnthai Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Thanawat Thumrongtaradol Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Surat Phumphuang Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Pornchai O-charoenrat Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University

Keywords:

Axillary staging, Breast cancer, Nodal metastasis, Nomogram, Sentinel lymph node

Abstract

Objectives: To evaluate risk factors for sentinel lymph node metastasis and validate value of the Memorial Sloan–Kettering Cancer Center (MSKCC) nomogram for the prediction of sentinel lymph node metastasis in Thai breast cancer patients.

Materials and Methods: Sentinel lymph node biopsy database containing 760 consecutive breast cancer patients was retrospectively analyzed. The predictive value of MSKCC nomogram was calculated by the trend line and the area under the receiver-operator characteristic curve. Meanwhile, predictors for sentinel lymph node metastasis were also evaluated.

Results: Tumor size, tumor type, tumor location, lymphovascular invasion, perineural invasion, multifocality, and progesterone receptor status were significant independent predictors for sentinel lymph node metastasis (all p < 0.05). The MSKCC nomogram presented an area under the receiver–operator characteristic curve value of 0.73. Patients with predictive value less than 12% had a frequency of sentinel lymph node metastasis of 0%. Those with values higher than 80% had a chance of sentinel lymph node metastasis of 78.3%.

Conclusions: The risk factors for sentinel lymph node metastasis in our study were partly similar to those in the MSKCC nomogram. The MSKCC nomogram is a useful tool that could accurately predict the probability of sentinel lymph node metastasis in our breast cancer patients. Axillary surgical staging might be avoided in patients with a predictive value of < 12% and axillary lymph node dissection might be performed in those with a predictive value of > 80%, while other patients should still require sentinel lymph node biopsy.

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Published

2020-06-30

How to Cite

1.
Nimboriboonporn A, Sa-nguanraksa D, Samarnthai N, Thumrongtaradol T, Phumphuang S, O-charoenrat P. Predictive Factors for Sentinel Lymph Node Metastasis and Validation of Memorial Sloan–Kettering Cancer Center Nomogram in Thai Breast Cancer Patients: Predictive Factors for Sentinel Node Metastasis. Thai J Surg [Internet]. 2020 Jun. 30 [cited 2024 Dec. 23];41(2):29-3. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/241208

Issue

Vol. 41 No. 2 (2020): April - June

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.