Prediction of non-sentinel lymph node status in breast cancer patients with sentinel lymph node metastases: evaluation of the tenon score.

Content Provider	Europe PMC
Author	Andersson, Y Frisell, J de Boniface, J Bergkvist, L
Copyright Year	2012
Abstract	IntroductionCurrent guidelines recommend completion axillary lymph node dissection (cALND) in case of a sentinel lymph node (SLN) metastasis larger than 0.2 mm. However, in 50%–65% of these patients, the non-SLNs contain no further metastases and cALND provides no benefit. Several nomograms and scoring systems have been suggested to predict the risk of metastases in non-SLNs. We have evaluated the Tenon score.Patients and MethodsIn a retrospective review of the Swedish Sentinel Node Multicentre Cohort Study, risk factors for additional metastases were analysed in 869 SLN-positive patients who underwent cALND, using uni- and multivariate logistic regression models. A receiver operating characteristic (ROC) curve was drawn on the basis of the sensitivity and specificity of the Tenon score, and the area under the curve (AUC) was calculated.ResultsNon-SLN metastases were identified in 270/869 (31.1%) patients. Tumour size and grade, SLN status and ratio between number of positive SLNs and total number of SLNs were significantly associated with non-SLN status in multivariate analyses. The area under the curve for the Tenon score was 0.65 (95% CI 0.61–0.69). In 102 patients with a primary tumour <2 cm, Elston grade 1–2 and SLN metastases ≤2 mm, the risk of non SLN metastasis was less than 10%.ConclusionThe Tenon score performed inadequately in our material and we could, based on tumour and SLN characteristics, only define a very small group of patients in which negative non-sentinel nodes could be predicted.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC3273320&blobtype=pdf
Journal	Breast Cancer : Basic and Clinical Research [Breast Cancer (Auckl)]
Volume Number	6
PubMed Central reference number	PMC3273320
PubMed reference number	22346360
e-ISSN	11782234
DOI	10.4137/bcbcr.s8642
Language	English
Publisher	Libertas Academica
Publisher Date	2012-01-30
Access Restriction	Open
Rights License	This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited. © the author(s), publisher and licensee Libertas Academica Ltd.
Subject Keyword	breast cancer sentinel node metastases
Content Type	Text
Resource Type	Article
Subject	Oncology Cancer Research