TITLE

Non-Sentinel Lymph Node Metastasis Prediction in Breast Cancer with Metastatic Sentinel Lymph Node: Impact of Molecular Subtypes Classification

AUTHOR(S)
Reyal, Fabien; Belichard, Catherine; Rouzier, Roman; de Gournay, Emmanuel; Senechal, Claire; Bidard, Francois-Clement; Pierga, Jean-Yves; Cottu, Paul; Lerebours, Florence; Kirova, Youlia; Feron, Jean-Guillaume; Fourchotte, Virginie; Vincent-Salomon, Anne; Guinebretiere, Jean-Marc; Sigal-Zafrani, Brigitte; Sastre-Garau, Xavier; De Rycke, Yann; Coutant, Charles
PUB. DATE
October 2012
SOURCE
PLoS ONE;Oct2012, Vol. 7 Issue 10, Special section p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction To decipher the interaction between the molecular subtype classification and the probability of a non-sentinel node metastasis in breast cancer patients with a metastatic sentinel lymph-node, we applied two validated predictors (Tenon Score and MSKCC Nomogram) on two large independent datasets. Materials and Methods Our datasets consisted of 656 and 574 early-stage breast cancer patients with a metastatic sentinel lymph-node biopsy treated at first by surgery. We applied both predictors on the whole dataset and on each molecular immune-phenotype subgroups. The performances of the two predictors were analyzed in terms of discrimination and calibration. Probability of non-sentinel lymph node metastasis was detailed for each molecular subtype. Results Similar results were obtained with both predictors. We showed that the performance in terms of discrimination was as expected in ER Positive HER2 negative subgroup in both datasets (MSKCC AUC Dataset 1 = 0.73 [0.69--0.78], MSKCC AUC Dataset 2 = 0.71 (0.65--0.76), Tenon Score AUC Dataset 1 = 0.7 (0.65--0.75), Tenon Score AUC Dataset 2 = 0.72 (0.66--0.76)). Probability of non-sentinel node metastatic involvement was slightly under-estimated. Contradictory results were obtained in other subgroups (ER negative HER2 negative, HER2 positive subgroups) in both datasets probably due to a small sample size issue. We showed that merging the two datasets shifted the performance close to the ER positive HER2 negative subgroup. Discussion We showed that validated predictors like the Tenon Score or the MSKCC nomogram built on heterogeneous population of breast cancer performed equally on the different subgroups analyzed. Our present study re-enforce the idea that performing subgroup analysis of such predictors within less than 200 samples subgroup is at major risk of misleading conclusions.
ACCESSION #
83523585

 

Related Articles

  • Intracystic papillary breast cancer: a clinical update. Al Reefy, Sara; Kameshki, Rashid; Al Sada, Dhabya; Al Elewah, Abdullah; Al Awadhi, Arwa; Al Awadhi, Kamil // Ecancermedicalscience;2013, Vol. 7 Issue 286-298, p1 

    Introduction: Intracystic (encysted) papillary cancer (IPC) is a rare entity of breast cancer accounting for approximately (1-2%) of all breast tumours [1], usually presenting in postmenopausal women and having an elusive natural history. The prediction of the biological behaviour of this rare...

  • Evaluating One Day Versus Two Days Preoperative Lymphoscintigraphy Protocols for Sentinel Lymph Node Biopsy in Breast Cancer. MOUNT, MICHAEL G.; WHITE, NICHOLAS R.; NGUYEN, CHRISTOPHE L.; ORR, RICHARD K.; HIRD, ROBERT B. // American Surgeon;May2015, Vol. 81 Issue 5, p454 

    Sentinel lymph node biopsy (SLNB) is used to detect axillary lymph node metastases in breast cancer. Preoperative radiocolloid injection with lymphoscintigraphy (PL) is performed before SLNB. Few comparisons between 1- and 2-day PL protocols exist. Opponents of a 2-day protocol have expressed...

  • Positive SLNB in thin melanomas predicted disease progression, death.  // Hem/Onc Today;10/25/2013, Vol. 14 Issue 20, p52 

    The article presents the results of a retrospective review as of late October 2013, which showed that a positive sentinel lymph node biopsy in patients with thin melanomas predicted distant metastasis, disease progression and death.

  • ASCO: SLNB an option for more women with operable breast cancer.  // Hem/Onc Today;5/25/2014, Vol. 15 Issue 10, p35 

    The article discusses research being done on the use of sentinel lymph node biopsy among patients with early-stage breast cancer, which references a study by G. H. Lyman et al. published in a 2014 issue of the "Journal of Clinical Oncology."

  • Corrections and clarifications.  // BMJ: British Medical Journal;1/19/2013, Vol. 346 Issue 7891, p18 

    A correction to the article “Sentinel node biopsy for melanoma: unnecessary treatment?” that was published in the January 8, 2013 issue is presented.

  • The Initial Implementation of the Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer Management in Malta. Gail, Camilleri; Karen, Borg Grima; Francis, Zarb // Journal of Cancer Therapy;May2013, Vol. 4 Issue 3, p765 

    Over the past two decades, the sentinel lymph node biopsy (SLNB) based on sentinel node (SN) being the first lymph node that harbors metastases, revolutionized breast cancer management. SLNB presents much less morbidity when compared to radical axillary lymph node dissection (ALND) where all...

  • Quality indicators for sentinel lymph node biopsy: Is there room for improvement? Acuna, Sergio A.; Angarita, Fernando A.; McCready, David R.; Escallon, Jaime // Canadian Journal of Surgery;Apr2013, Vol. 56 Issue 2, p82 

    Background: Eleven quality indicators (QIs) for sentinel lymph node biopsy (SLNB) were previously developed through a consensus-based approach, yet still need to be incorporated into clinical practice. We sought to evaluate the applicability and clinical relevance for surgeons. Methods: Breast...

  • Nodal metastases of soft tissue sarcomas: risk factors, imaging findings, and implications. Rosenthal, Jeffrey; Cardona, Kenneth; Sayyid, Samia K.; Perricone, Adam J.; Reimer, Nickolas; Monson, David; Singer, Adam Daniel // Skeletal Radiology;Feb2020, Vol. 49 Issue 2, p221 

    Soft tissue sarcomas (STS) are malignancies derived from connective tissue, and regional lymph node metastasis (RLNM), while not common, is an important aspect of prognosis and treatment. Various risk factors, in particular the histological subtype, affect the likelihood of nodal involvement,...

  • Indication du curage axillaire en cas de ganglion sentinelle envahi - essais cliniques. Houvenaeghel, G.; Cohen, M.; Chereau Ewald, E.; Bannier, M.; Buttarelli, M.; Lambaudie, E. // Oncologie;Jun2013, Vol. 15 Issue 6, p311 

    Axillary lymph node dissection (ALND) for micro- or macrometastases in sentinel node is questioned by recent trial results. We reported some results of the following questions: 1) What is the non-sentinel node rate in case of involved sentinel node? 2)What is the impact of ALND omission on...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics