AI Summary & Key Takeaways
AI InsightNevertheless, the omission of ALNB in SLNB-positive breast cancer cannot be yet recommended because of the lack of long-term results of current nomograms and scoring systems.
📌 3 Key Takeaways
Abstract
Objective: The aim of this retrospective clinical study was to evaluate the accuracy and feasibility of two different clinical scales, namely the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Tenons axillary scoring system, which were developed for predicting the non-sentinel lymph node (NSLN) status in our breast cancer patients. Material and Methods: The medical records of patients who were diagnosed with breast cancer between January 2010 and November 2013 were reviewed. Those who underwent sentinel lymph node biopsy (SLNB) for axillary staging were recruited for the study, and patients who were found to have positive SLNB and thus were subsequently subjected to axillary lymph node dissection (ALND) were also included. Patients who had neoadjuvant therapy, who had clinically positive axilla, and who had stage 4 disease were excluded. Patients were divided into two groups. Group 1 included those who had negative NSLNs, whereas Group 2 included those who had positive NSLNs. The following data were collected: age, tumor size, histopathological characteristics of the tumor, presence of lymphovascular invasion, presence of multifocality, number of negative and positive NSLNs, size of metastases, histopathological method used to define metastases, and receptor status of the tumor. The score of each patient was calculated according to the MSKCC nomogram and Tenons axillary scoring system. Statistical analysis was conducted to investigate the correlation between the scores and the involvement of NSLNs. Results: The medical records of patients who were diagnosed with breast cancer and found to have SLNB for axillary staging was reviewed. Finally, 50 patients who had positive SLNB and thus were subsequently subjected to ALND were included in the study. There were 17 and 33 patients in Groups 1 and 2, respectively. Both the MSKCC nomogram and Tenons axillary scoring system were demonstrated to be significantly accurate in the prediction of the involvement of NSLNs (p<0.05 for each). Among all the parameters, the only one that was found to be correlated with the risk of NSLN involvement was the presence of lymphovascular invasion. Conclusion: The MSKCC nomogram and Tenons axillary scoring system both seem to be reliable tools for the assessment of NSLN status in SLNB-positive breast cancer in our breast cancer population. Nevertheless, the omission of ALNB in SLNB-positive breast cancer cannot be yet recommended because of the lack of long-term results of current nomograms and scoring systems.
Özet
Amaç: Retrospektif klinik çalışmamızda sentinel dışı lenf nodu (SDLN) metastaz riskini hesaplamak için geliştirilen Memorial Sloan-Kettering Cancer Center (MSKCC) nomogramı ve Tenon aksilla skorlama sisteminin meme kanserli hastalarımızda kullanılabilirliklerinin ve doğruluklarının de- ğerlendirilmesi amaçlandı. Yöntem ve Gereçler: Hastanemizde Ocak 2010 - Ekim 2013 tarihleri arasında meme kanseri tanısıyla ameliyat edilen ve sentinel lenf nodu biyopsisi (SLNB) yapılmış hastaların dosyaları retrospektif olarak incelendi. SLNB pozitif olan ve aksiller lenf nod diseksiyonu (ALND) yapılan hastalar çalışmaya dahil edildi. Neoadjuvan tedavi alan, aksillada palpe edilebilen lenf nodu olan ve evre 4 hastalığı olan hastalar çalışmaya dahil edilmedi. Sentinel dışı lenf nodu (SDLN) negatif (Grup 1) ve SDLN pozitif hasta (Grup 2) olmak üzere iki grup tanımlandı. Hastaların yaşı, tümör çapı ve histolojisi, gradei, lenfatik invazyon varlığı, multifokalite varlığı, metastaz olan sentinel lenf nodu (SLN) sayısı ve metastaz olmayan SLN sayısı, SLNdeki metastazın büyüklüğü, SLNdeki metastazın patolojik saptama yöntemi ve reseptör durumu kaydedildi. Her bir hasta için SDLN metastaz riski MSKCC nomogramı ve Tenon aksilla skorlama sistemi ile hesaplandı. Risk skorları ile SDLN tutulumu arasındaki ilişki istatiksel olarak araştırıldı. Bulgular: Meme kanseri tanısı alan ve aksiller evreleme için SLNB yapılan hastaların dosyaları retrospektif olarak incelendi. SLNB pozitif olup ALND yapılan 50 hasta çalışmaya dahil edildi. Grup 1de 17 hasta, Grup 2de 33 hasta mevcuttu. Memorial Sloan-Kettering Cancer Center Nomogramı ve Tenon aksilla skorlama sisteminin SDLN tutulumunun tahmininde istatistiksel olarak anlamlı uygun modeller oldukları görüldü (p<0,05). Lenfovasküler invazyon varlığının tüm parametreler arasında SDLN tutulumunu etkileyen tek parametre olduğu görüldü. Sonuç: MSKCC nomogramı ve Tenon aksilla skorlama sisteminin SLNB pozitif meme kanserli hasta popülasyonumuzda SDLN metastaz riskinin değerlendirilmesinde kullanılabilir modeller oldukları görülmektedir. Bununla birlikte SLNB pozitif meme kanserli hastalarda ALNDnin terk edilmesi, nomogram ve skorlama sistemlerinin uzun dönem sonuçları bilinmediği için henüz önerilmemektedir.