Ontology highlight
ABSTRACT: Purpose
The American College of Surgeons Oncology Group Z0011 trial reported that complete dissection of axillary lymph nodes (ALNs) may not be warranted in women with clinical T1-T2 tumors and one or two involved ALNs who were undergoing lumpectomy plus radiation followed by systemic therapy. The present study was conducted to identify preoperative imaging predictors of ? 3 ALNs.Materials and methods
The training set consisted of 1,917 patients with clinical T1-T2 and node negative invasive breast cancer. Factors associated with ? 3 involved ALNs were evaluated by logistic regression analysis. The validation set consisted of 378 independent patients. The nomogram was applied prospectively to 512 patients who met the Z0011 criteria.Results
Of the 1,917 patients, 204 (10.6%) had ? 3 positive nodes. Multivariate analysis showed that involvement of ? 3 nodes was significantly associated with ultrasonographic and chest computed tomography findings of suspicious ALNs (p < 0.001 each). These two imaging criteria, plus patient age, were used to develop a nomogram calculating the probability of involvement of ? 3 ALNs. The areas under the receiver operating characteristic curve of the nomogram were 0.852 (95% confidence interval [CI], 0.820 to 0.883) for the training set and 0.896 (95% CI, 0.836 to 0.957) for the validation set. Prospective application of the nomogram showed that 60 of 512 patients (11.7%) had scores above the cut-off. Application of the nomogram reduced operation time and cost, with a very low re-operation rate (1.6%).Conclusion
Patients likely to have ? 3 positive ALNs could be identified by preoperative imaging. The nomogram was helpful in selective intraoperative examination of sentinel lymph nodes.
SUBMITTER: Ahn SK
PROVIDER: S-EPMC5654155 | biostudies-literature | 2017 Oct
REPOSITORIES: biostudies-literature
Ahn Soo Kyung SK Kim Min Kyoon MK Kim Jongjin J Lee Eunshin E Yoo Tae-Kyung TK Lee Han-Byoel HB Kang Young Joon YJ Kim Jisun J Moon Hyeong-Gon HG Chang Jung Min JM Cho Nariya N Moon Woo Kyung WK Park In Ae IA Noh Dong-Young DY Han Wonshik W
Cancer research and treatment 20170125 4
<h4>Purpose</h4>The American College of Surgeons Oncology Group Z0011 trial reported that complete dissection of axillary lymph nodes (ALNs) may not be warranted in women with clinical T1-T2 tumors and one or two involved ALNs who were undergoing lumpectomy plus radiation followed by systemic therapy. The present study was conducted to identify preoperative imaging predictors of ≥ 3 ALNs.<h4>Materials and methods</h4>The training set consisted of 1,917 patients with clinical T1-T2 and node negat ...[more]