RT Journal Article
SR Electronic
T1 Predicting Nonsentinel Lymph Node Metastasis Using Lymphoscintigraphy in Patients with Breast Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1693
OP 1700
DO 10.2967/jnumed.112.106260
VO 53
IS 11
A1 Hyo Sang Lee
A1 Seok Won Kim
A1 Byoung-Hee Kim
A1 So-Youn Jung
A1 Seeyoun Lee
A1 Tae-sung Kim
A1 Youngmi Kwon
A1 Eun Sook Lee
A1 Han-Sung Kang
A1 Seok-ki Kim
YR 2012
UL http://jnm.snmjournals.org/content/53/11/1693.abstract
AB Several models for predicting the likelihood of nonsentinel lymph node (NSLN) metastasis using histopathologic parameters in sentinel-positive breast cancer patients have been proposed. In this study, we established a new model that uses sentinel lymphoscintigraphic findings and histopathologic parameters as covariates and assessed its predictive performance. Methods: The analysis included breast cancer patients (n = 301 women) who underwent sentinel lymphoscintigraphy (SLS) using 99mTc-labeled human serum albumin, had sentinel lymph node biopsy results positive for metastasis, and subsequently underwent complete axillary lymph node dissection. First, we devised a grading system relating SLS patterns to the risk of NSLN metastasis positivity. Second, we developed a multivariate logistic regression model for the prediction of NSLN metastasis using the SLS pattern and histopathologic parameters as covariates and compared its performance with that of the extensively validated Memorial Sloan-Kettering Cancer Center model using receiver-operating-characteristic curve analysis. Results: The SLS visual grade was strongly correlated with the presence of NSLN metastases. A well-calibrated prediction model for NSLN metastasis was constructed using SLS grade and histopathologic findings. The mean area under the curve of our model was 0.812, which is significantly greater than that of the Memorial Sloan-Kettering Cancer Center model (P < 0.001). A nomogram was drawn to facilitate the application of our model. Conclusion: SLS can aid in predicting NSLN metastasis in patients with breast cancer. Our model performed better than did established prediction models.