J Nucl Med. 2008; 49 (Supplement 1):262P
General Clinical Specialties: General Practice-OncologyGeneral Practice-Oncology Posters |
Single institutional experience with breast cancer nomogram for positive sentinel lymph node patients
Lena Pinkas1,
Ella Tepper2,
Vladler Simonovsky1,
Eli Mavor3 and
Noa Efrat (Ben-Baruh)2
1 Nuclear Medicine;
2 Oncology;
3 Surgery, Kaplan Medical Center, Rehovot, Israel
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Objectives: There is no consensus in the current literature on the role of axillary lymph node dissection (ALND) for breast cancer patients with positive sentinel lymph nodes (SLN.The breast cancer nomogram was developed by the Memorial Sloan-Kettering Cancer Center as an online tool (http://www.mskcc.org/mskcc/html/15938.cfm)for predicting the risk of positive non-SLN in SLN-positive patients.
Methods: In the present study we applied the nomogram on the group of 45 breast cancer patients with positive SLN biopsy who underwent consequent ALND. 383 breast cancer patients underwent preoperative scintigraphic SLN visualization following a periareolar intradermal injection of 3.7 MBq Tc99m nanocolloid. The procedure was performed 2-4 hours before a gamma-probe guided axillary lymph node biopsy. Post-operative pathological and immunohistochemical correlations were done.
Results: SLN visualization was achieved in 378 (98.7%)patients. Metastatic SLN disease was found in 47 patients, and in 27 of them the SLNs were the only positive nodes. Two patients with false-negative SLN were excluded from the study.
Conclusions: Patients with positive SLN biopsy and ALND had a trend for a higher calculated probability for additional positive nodes. Applying the nomogram would therefore appear to be useful as an additional tool in the decision-making process.
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The results of the predictive nomogram in the two groups
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