Abstract:

Our goal is to explore the factors affecting the positiveness of the non-centric lymphatic nodes (NSLN) in the positive breast cancer and to compare the effectiveness of the Memorial Sloan-Kettering Cancer Center (MSKCC) and Stanford nomograms in our patient group. Methods: Between 01.01.2008 and 31.08.2011 112 patients with invasive breast cancer found metastases in the sentinel lymphatic nodus as a result of the sentinel lymphatic nodus biopsy (SLNB) in the General Surgery Clinic of the University of Onto May Medical School were taken to study. The variables to be compared were recorded using the SPSS version 15.0 program. The logistical regression analysis examined the risk factors affecting the NSLN positivity. P< 0.05 is considered to be the meaning level. For both nomograms the "Receiver Operating Characteristics (ROC)" curves were created and the fields under the curves (AUCs) were calculated. The AUC value is 0.70 and above and the calculated method was effectively accepted. Results: In single variable analysis, the tumor size, multifocality, the presence of lymphovascular invasion, the formation of macrometastasis of metastases in SLN, the presence of non-capsular invasion in SLN and the percentage of the total number of SLN of the metastatic SLN were found meaningful. In multiple variable analysis, lymphovascular invasion, non-capsular invasion in SLN and the ratio of metastatic SLN to the total number of SLN were determined as independent predictive factors related to NSLN metastasis. While both of the MSKCC and Stanford nomograms are active in our patient group, we have found that the MSKCC nomogram is more effective. Result: Nomograms are guiding methods on the possibility of metastatase in the NSLN. But they are not yet able to replace the lymphatic nodus disection (ALND). The exposure of new predictive factors that affect the NSLN positivity can increase the effectiveness. Each clinic should determine and use its own nomogram or create its own nomogram.

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