medical decision support medical decision support
Sign In

Model of Viale et al for Predicting Risk of Metastasis to Axillary Sentinel Lymph Nodes in a Patient with Breast Cancer

Description

Viale et al identified risk factors associated with metastasis to axillary sentinel lymph nodes in patients with breast cancer. These can help stratify patients based on the risk of nodal metastasis. The authors are from the Universities of Milan and Bari in Italy.


 

Factors associated with an increase risk of sentinel nodal metastasis:

(1) tumor size (> 2 cm most, <= 0.5 cm least)

(2) multifocal breast involvement

(3) peritumoral vascular invasion (PVI)

 

Factors associated with a decreased risk of sentinel nodal metastasis:

(1) favorable histology (medullary, cribriform, tubular or mucinous)

(2) negative progesterone receptor status

Features

Tumor Diameter

< 1 cm

Tumor Diameter

1 - 2 cm

Tumor Diameter > 2 cm

PVI negative

favorable histology

10%

16%

12%

PVI negative

ductal or lobular

unifocal

15%

26%

38%

PVI negative

ductal or lobular

multifocal

18%

38%

62%

PVI positive

57%

66%

77%

after Table 4, page 497

 

where:

• A low risk group is 10-18%, moderate risk 26-38% and high risk 57-77%.

• I could not find how tumor size was handled with multifocal tumors. One option is the size of the largest tumor. The second is somehow combining dimensions of each focus; simple addition of diameters would be inadequate.

 


To read more or access our algorithms and calculators, please log in or register.

Specialty