Nomogram Addresses Breast Cancer Concerns

User-friendly prediction model can calculate odds of metastasis to the lymph nodes

THURSDAY, Aug. 16 (HealthDay News) -- A user-friendly nomogram can help answer the questions of newly diagnosed breast cancer patients about their patient-specific likelihood of developing sentinel lymph node metastasis, according to a report published in the Aug. 20 issue of the Journal of Clinical Oncology.

Kimberly J. Van Zee, M.D., of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues analyzed data from 3,786 sentinel lymph node biopsies to develop a model to predict the presence of breast cancer metastasis. From this they created a user-friendly prediction model, or nomogram.

The factors associated with sentinel lymph node metastasis were: age; tumor type, size and location; lymphovascular invasion; multifocality; and estrogen and progesterone receptors. The nomogram was able to accurately discriminate the risk factors in individual cases and calculate the probability of metastasis to the lymph nodes.

"This nomogram provides an accurate, accessible, multivariate predictive model," the authors conclude. "This model and its computer application represent a significant improvement over our intuition or theorization based on subjectivity and guesstimates. Finally, it provides the precise and deserved answer to our patient's question: Doctor, what are my chances of having a positive sentinel lymph node?" The nomogram has been posted on the Memorial Sloan-Kettering Cancer Center Web site.

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