PresentationNonsentinel node metastasis in breast cancer patients: assessment of an existing and a new predictive nomogram
Section snippets
Materials and Methods
Medical records were reviewed for 574 consecutive breast cancer patients with a positive SLNB who underwent CALND from October 1997 to November 2002 at the University of Michigan (n = 109) and from November 1997 to June 2004 at the Mayo Clinic (n = 465). Patients with histopathologically diagnosed primary invasive breast cancer with a clinically negative axilla, successful SLNB with metastatic disease, and subsequent CALND were included in the study. The study was reviewed and approved by
Results
Our study group consisted of 574 patients; 109 from the University of Michigan and 465 from the Mayo Clinic. The mean age of the patients in the Mayo dataset was 57 years (range, 26–88 years), and the mean age of the patients in the Michigan dataset was 53 years (range, 31–78 years). Among the Mayo patients, 203 (44%) had additional positive NSNs. Among the Michigan patients, this number was 36 (33%). Table 1 shows the descriptive patient and tumor characteristics, including missing frequencies
Comments
SLNB examination has become the standard of care for assessing nodal status in breast cancer. However, the surgical management of patients with metastatic disease in the SNs is controversial. In approximately 40% to 60% of patients, the SN is the sole site of regional node metastasis, and these patients would not be expected to benefit from ALND [2]. The American College of Surgeons Oncology Group Z0011 trial, which randomized SN-positive patients to CALND or to no further axillary surgery, has
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