A decision tool for predicting sentinel node accuracy from breast tumor size and grade

Coombs, Nathan, Chen, Wanqing, Taylor, Richard and Boyages, John (2007) A decision tool for predicting sentinel node accuracy from breast tumor size and grade. Breast Journal, 13 6: 593-598. doi:10.1111/j.1524-4741.2007.00507.x

Author Coombs, Nathan
Chen, Wanqing
Taylor, Richard
Boyages, John
Title A decision tool for predicting sentinel node accuracy from breast tumor size and grade
Journal name Breast Journal   Check publisher's open access policy
ISSN 1075-122X
Publication date 2007
Sub-type Article (original research)
DOI 10.1111/j.1524-4741.2007.00507.x
Volume 13
Issue 6
Start page 593
End page 598
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell
Language eng
Subject 11 Medical and Health Sciences
1112 Oncology and Carcinogenesis
Abstract The ability to predict axillary lymph node involvement in breast cancer patients in the preoperative setting is invaluable. This study provides a simple set of formulae to enable clinicians to make informed decisions in the management of screen-detected breast cancer. The tumor pathology reports were obtained of all 4,585 women identified between 1996 and 1999 in New South Wales (NSW) with T1 or T2 breast cancer by the statewide co-ordinated breast screening service (BreastScreen NSW). Equations predicting node positivity were calculated by linear regression analysis and, from published sentinel node false-negative rates, the probability of retrieval of a false-negative axillary lymph node by sentinel node biopsy was calculated for tumors of different size and grade. Node involvement was identified in 1,089 (23.8%) of women. A linear relationship for tumor size, grade, and nodal involvement was predicted by: frequency (%) = 1.5 × tumor size (mm) + 2 (or 6 or 10) for grade I (or II or III) tumors. Assuming a 7.5% false-negative rate, the probability of retrieving a false-negative sentinel node ranged from 0.8% for a patient with a 5 mm, grade I carcinoma to 6.0% for a 50 mm, grade III tumor. These simple formulae are easy to use in a clinical setting. The reference table enables breast surgeons to inform a patient about the absolute probability of false-negative sentinel biopsy rates for patients with screen-detected carcinomas when size can be estimated from preoperative imaging and when tumor grade is often available from preoperative core biopsy. Patients with large, T2 breast tumors may be best treated with axillary dissection rather than sentinel node biopsy alone due to the risk of under-staging the woman's disease and also the high probability of finding a positive sentinel node.
Keyword Breast tumor grade
Breast tumor size
Predicting accuracy
Decision tool
Sentinel lymph node biopsy
Q-Index Code C1
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
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Created: Fri, 28 Mar 2008, 16:42:24 EST