Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node

T F Tvedskov; T J Meretoja; M B Jensen; M Leidenius; N Kroman

doi:10.1016/j.ejso.2014.01.014

Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node

T F Tvedskov, T J Meretoja, M B Jensen, M Leidenius, N Kroman

Department of Clinical Medicine

18 Citations (Scopus)

Abstract

BACKGROUND: We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment.

MATERIAL AND METHOD: Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort.

RESULTS: The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22% of the patients as high-risk patients with over 30% risk of non-sentinel node metastases while less than 1% was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases.

CONCLUSION: The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.

Original language	English
Journal	European Journal of Surgical Oncology
Volume	40
Issue number	4
Pages (from-to)	435-441
Number of pages	7
ISSN	0748-7983
DOIs	https://doi.org/10.1016/j.ejso.2014.01.014
Publication status	Published - Apr 2014

Keywords

Adult
Aged
Area Under Curve
Breast Neoplasms
Carcinoma, Ductal, Breast
Carcinoma, Lobular
Denmark
Female
Finland
Humans
Lymph Node Excision
Lymph Nodes
Lymphatic Metastasis
Middle Aged
Models, Statistical
Neoplasm Grading
Neoplasm Micrometastasis
Neoplasm Staging
Predictive Value of Tests
Risk Assessment
Risk Factors
Sentinel Lymph Node Biopsy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejso.2014.01.014

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Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node. / Tvedskov, T F; Meretoja, T J; Jensen, M B et al.
In: European Journal of Surgical Oncology, Vol. 40, No. 4, 04.2014, p. 435-441.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node",

abstract = "BACKGROUND: We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment.MATERIAL AND METHOD: Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort.RESULTS: The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22% of the patients as high-risk patients with over 30% risk of non-sentinel node metastases while less than 1% was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases.CONCLUSION: The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.",

keywords = "Adult, Aged, Area Under Curve, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Denmark, Female, Finland, Humans, Lymph Node Excision, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Models, Statistical, Neoplasm Grading, Neoplasm Micrometastasis, Neoplasm Staging, Predictive Value of Tests, Risk Assessment, Risk Factors, Sentinel Lymph Node Biopsy",

author = "Tvedskov, {T F} and Meretoja, {T J} and Jensen, {M B} and M Leidenius and N Kroman",

year = "2014",

month = apr,

doi = "10.1016/j.ejso.2014.01.014",

language = "English",

volume = "40",

pages = "435--441",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

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TY - JOUR

T1 - Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node

AU - Tvedskov, T F

AU - Meretoja, T J

AU - Jensen, M B

AU - Leidenius, M

AU - Kroman, N

PY - 2014/4

Y1 - 2014/4

N2 - BACKGROUND: We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment.MATERIAL AND METHOD: Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort.RESULTS: The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22% of the patients as high-risk patients with over 30% risk of non-sentinel node metastases while less than 1% was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases.CONCLUSION: The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.

AB - BACKGROUND: We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment.MATERIAL AND METHOD: Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort.RESULTS: The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22% of the patients as high-risk patients with over 30% risk of non-sentinel node metastases while less than 1% was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases.CONCLUSION: The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.

KW - Adult

KW - Aged

KW - Area Under Curve

KW - Breast Neoplasms

KW - Carcinoma, Ductal, Breast

KW - Carcinoma, Lobular

KW - Denmark

KW - Female

KW - Finland

KW - Humans

KW - Lymph Node Excision

KW - Lymph Nodes

KW - Lymphatic Metastasis

KW - Middle Aged

KW - Models, Statistical

KW - Neoplasm Grading

KW - Neoplasm Micrometastasis

KW - Neoplasm Staging

KW - Predictive Value of Tests

KW - Risk Assessment

KW - Risk Factors

KW - Sentinel Lymph Node Biopsy

U2 - 10.1016/j.ejso.2014.01.014

DO - 10.1016/j.ejso.2014.01.014

M3 - Journal article

C2 - 24534362

SN - 0748-7983

VL - 40

SP - 435

EP - 441

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 4

ER -

Cross-validation of three predictive tools for non-sentinel node metastases in breast cancer patients with micrometastases or isolated tumor cells in the sentinel node

Abstract

Keywords

UN SDGs

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