Nomogram of Hennessy et al for Predicting Residual Tumor in Axillary Lymph Nodes Following Primary Chemotherapy for Breast Carcinoma

Parameters:

(1) estrogen receptor (ER) status

(2) histologic grade for the breast cancer

(3) age of the patient in years

points for age =

= (-1.9595 * (age in years)) + 147.0885

where:

• The table shows ages from 25 to 75 years. For a patient > 75 years 0 points are assigned.

total score =

= SUM(points for all 3 parameters)

linear predictor =

= (0.01066 * (total score)) - 0.9770

probability of positive axillary lymph nodes on histology =

= 1 / (1 + EXP((-1) * (linear predictor)))

Limitations:

• The lowest probability is 30%. The maximum total score approximates a linear predictor =2, with a probability of residual tumor of 88%. The lymph nodes still need to be sampled for histologic examination no matter what the nomogram says.