Chances of having a positive sentinel lymph node – Evalutation of a nomogram for prediction of sentinel lymph node positivity in a German breast cancer population

Aims: The sentinel lymph node (SLN) procedure could be omitted in cases of an accurate prediction of a very high or very low probability of sentinel lymph node (SLN) metastasis in early breast cancer patients. We evaluated a breast cancer nomogram, an online tool provided by the Memorial Sloan Kettering Cancer Center (MSKCC) that predicts the likelihood of a positive lymph node.

Methods: Data from 545 patients with successful SLN biopsy were collected, including 118 patients with a positive sentinel lymph node. Histopathological assessment of the SLN included hematoxylin and/or immunohistochemnistry. Predictive accuracy was assessed by calculating the area under the receiver-operator characteristic (ROC) curve.

Results: In our collective tumor size, histology, lymphovascular infiltration, multifocality, Her–2-neu positivity, and nuclear grade correlated with the probability of SLN metastasis. The trend of actual probability compared to the predicted probability in the decile groups 0–90 was comparable. The ROC revealed a value of 0.78 compared to 0.75 in the original publication.

Discussion: The MSKCC nomogram is a useful tool in our population of breast cancer patients. Variations in pathological assessments between the breast cancer centers worldwide might be an impediment to the widespread application of the nomogram.

breast cancer - nomogram - predictive tool - sentinel lymph node