ArticleBreast (Edinburgh, Scotland)2020
Development and external validation of a nomogram to predict four or more positive nodes in breast cancer patients with one to three positive sentinel lymph nodes.
Article in Breast (Edinburgh, Scotland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 22 citations in OpenAlex.
- Prediction model to prevent axillary surgery using axillary US and MRI in early breast cancer.European radiology · 2026Article
- Evaluating total tumor load (TTL) to predict metastasis in four or more axillary lymph nodes in HR +/HER2- breast cancer patients: the TULIP4N + study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Retrospective study on regional nodal irradiation after omission of axillary lymph node dissection in sentinel lymph node-positive breast cancer: a propensity score matching analysis.Breast cancer research and treatment · 2026Article
- Omitting axillary lymph node dissection or not? A multicenter, retrospective study for breast cancer patients potentially eligible for abemaciclib since the SENOMAC trial.World journal of surgical oncology · 2026Article
- Machine learning for predicting high axillary nodal burden in breast cancer patients with positive sentinel lymph nodes.World journal of surgical oncology · 2026Article
- Anatomical location of metastatic sentinel lymph node and clinicopathological characteristics for predicting risk of non-sentinel lymph node metastasis.World journal of surgical oncology · 2026Article
- Development and internal validation of a nomogram for sleep quality among Chinese medical students: a cross-sectional study.BMC public health · 2025Article
- How can we optimize the surgical management of the axilla in breast cancer since the MonarchE trial?Breast cancer research and treatment · 2025Article
- Exploring the clinical value of regional nodal irradiation in sentinel lymph node positive breast cancer patients omitting axillary dissection.BMC cancer · 2025Article
- Advances in regional nodal management of early-stage breast cancer.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2024Article
- Nomograms for metastasis of non-sentinel lymph nodes or more than three lymph nodes in patients with one or two positive sentinel lymph nodes.Frontiers in oncology · 2024Article
- Optimization of regional nodal irradiation in the era of sentinel lymph node biopsy.Cancer biology & medicine · 2023Article
- A multi-dimensional nomogram to predict non-sentinel lymph node metastases in T1-2HR+ breast cancer.Frontiers in endocrinology · 2023Article
- Development and validation of a pre- and intra-operative scoring system that distinguishes between non-advanced and advanced axillary lymph node metastasis in breast cancer with positive sentinel lymph nodes: a retrospective study.World journal of surgical oncology · 2022Article
- A New Model for Predicting Nonsentinel Lymph Node Metastasis in Early-Stage Breast Cancer Using MMP15.Journal of oncology · 2022Article
- Candidates of Genomic Tests in HR+/HER2- Breast Cancer Patients With 1-2 Positive Sentinel Lymph Node Without Axillary Lymph Node Dissection: Analysis From Multicentric Cohorts.Frontiers in oncology · 2021Article
- Decreased Survival of Invasive Ductal Breast Cancer Patients With Two Macrometastatic Lymph Nodes Among Few Resected Ones: Should Current Sentinel-Lymph-Node Guidelines Be Revised?Frontiers in oncology · 2021Article
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Authors and funding
17 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo develop a nomogram for predicting the possibility of four or more positive nodes in breast cancer patients with 1-3 positive sentinel lymph nodes (SLN). MATERIALS AND
methodsRetrospective analysis of data of patients from two institutions was conducted. The inclusion criteria were: invasive breast cancer; clinically node negative; received lumpectomy or mastectomy plus SLN biopsy followed by axillary lymph node dissection (ALND); and pathologically confirmed T1-2 tumor, with 1-3 positive SLNs. Patients from one institution formed the training group and patients from the other the validation group. Univariate and multivariate analyses were performed to identify the predictors of four or more positive nodes. These predictors were used to build the nomogram. The area under the receiver operating characteristic curve (AUC) was calculated to assess the accuracy of the model.
resultsOf the 1480 patients (966 patients in the training group, 514 in the validation group), 306 (20.7%) had four or more positive nodes. Multivariate stepwise logistic regression showed number of positive (p < .001) and negative SLN (p < .001), extracapsular extension (p < .001), pT stage (p = .016), and tumor location in outer upper quadrant (p = .031) to be independent predictors of four or more positive nodes. The nomogram was built using these five factors. The AUC was 0.845 in the training group and 0.804 in the validation group.
conclusionThe proposed nomogram appears to accurately estimate the likelihood of four or more positive nodes and could help radiation oncologists to decide on use of regional nodal irradiation (RNI) for breast cancer patients with 1-3 positive nodes but no ALND.
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