NEW YORK, December 3, 2003 Researchers at Memorial Sloan-Kettering Cancer Center (MSKCC) have developed a new computerized tool called a nomogram that will help patients and their physicians calculate the likelihood of breast cancer spreading beyond the sentinel lymph nodes to additional lymph nodes under the arms (axilla). Further axillary lymph node metastasis is a key factor in determining whether a patient is likely to benefit from additional surgery to remove all of the nodes.

A new study published in the December issue of the Annals of Surgical Oncology demonstrates the accuracy of the nomogram. Investigators assessed the pathological features of the primary breast tumor and the sentinel lymph node metastasis of 702 breast cancer patients. Using that information, they developed nomogram calculations to predict the presence of additional disease in the axillary lymph nodes in those patients.

Study investigators then prospectively applied the nomogram to 373 patients whose breast cancer was detected through biopsy in the sentinel lymph nodes and found that the prognostic model accurately predicted the likelihood of axillary lymph node metastasis to within a few percentage points.

"This easy-to-use nomogram will allow patients and their physicians to obtain accurate estimates of a patient's risk for additional disease in the axillary lymph nodes, and can assist greatly in individualized decision-making regarding further treatment," said the study's lead author Kimberly Van Zee, MD, a breast cancer surgeon at MSKCC.

The nomogram takes several pathological factors into account, including tumor size; tumor type (ductal or lobular); estrogen-receptor status of the primary tumor; the method of detection of sentinel lymph node metastases (frozen section analysis, routine analysis, or enhanced pathologic analysis); and the number of positive and negative sentinel lymph nodes.

"There are many variables affecting the probability of a
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Contact: Esther Carver or Melanie Johnson
mediastaff@mskcc.org
212-639-3573
Memorial Sloan-Kettering Cancer Center
3-Dec-2003

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