RESUMEN
PURPOSE: To evaluate the predicting factors for non-sentinel lymph node (SLN) metastases in T1-2 invasive breast cancer with 1-2 metastatic SLN that fully matched the ACOSOG Z0011 criteria. Also, to develop a scoring system to predict the risk of non-SLN metastasis and to discriminate the low-risk patients for omission of the axillary lymph node dissection (ALND) in this population. METHODS: Two hundred and seven T1-2 invasive breast cancer patients with 1-2 metastatic SLN who underwent ALND at our Institution were included in the study. Independent factors predicting the non-SLN metastasis were found using logistic regression analysis, and a scoring system to predict the non-SLN metastasis was created. RESULTS: Seventy (34%) out of 207 patients had non- SLN metastasis. Multivariate logistic regression analysis demonstrated that tumor size, presence of lymphovascular invasion (LVI), number of negative SLNs, and size of SLN metastasis were independent factors predicting non-SLN metastasis. There were 68 (33%) and 108 (52%) patients with a the score of ? 4 (predicted probability of ?10%) with a false negative rate (FNR) of 4.4%, and ?5 (predicted probability of ?15%) with a FNR of 7.4%, respectively. The area under the curve (AUC) value for the Ondokuz Mayis scoring system was 0.88 (95% CI 0.83-0.93). CONCLUSIONS: The present Ondokuz Mayis model with an AUC of 0.88 showed excellent discrimination capacity to distinguish patients at low risk for positive non-SLN from high risk patients and could help spare ALND in an important portion of patients.
Asunto(s)
Neoplasias de la Mama/patología , Técnicas de Apoyo para la Decisión , Ganglios Linfáticos/patología , Adulto , Anciano , Área Bajo la Curva , Neoplasias de la Mama/cirugía , Reacciones Falso Negativas , Femenino , Humanos , Modelos Logísticos , Escisión del Ganglio Linfático , Ganglios Linfáticos/cirugía , Metástasis Linfática , Persona de Mediana Edad , Análisis Multivariante , Invasividad Neoplásica , Oportunidad Relativa , Selección de Paciente , Valor Predictivo de las Pruebas , Curva ROC , Reproducibilidad de los Resultados , Medición de Riesgo , Factores de Riesgo , Ganglio Linfático Centinela/patología , Biopsia del Ganglio Linfático Centinela , Turquía , Procedimientos InnecesariosRESUMEN
In this article published in Volume 21, issue 5, the Results section of the Pubmed abstract appeared as: "There were 68 (33%) and 108 (52%) patients with a the score of ? 4 (predicted probability of ?10%) with a false negative rate (FNR% of 4.4%, and ?5 (predicted probability of ?15%) with a FNR of 7.4%, respectively. The area under the curve (AUC) value for the Ondokuz Mayis scoring system was 0.88 (95% CI 0.83-0.93%)." The correct Results section of the abstract is: "There were 68 (33%) and 108 (52%) patients with a the score of ≤4 (predicted probability of ≤10%) with a false negative rate (FNR) of 4.4%, and ≤5 (predicted probability of ≤15%) with a FNR of 7.4%, respectively. The area under the curve (AUC) value for the Ondokuz Mayis scoring system was 0.88 (95% CI 0.83-0.93)." This error appeared only in the PubMed database and not in the print form of the Journal.