AB051. SOH25_AB_129. One less surgery: predicting non-sentinel lymph node metastasis in patients with breast cancer and positive sentinel node biopsy using nomogram in the Irish cohort
General Surgery I

AB051. SOH25_AB_129. One less surgery: predicting non-sentinel lymph node metastasis in patients with breast cancer and positive sentinel node biopsy using nomogram in the Irish cohort

Alan O’Doherty1, Yeong Huei Desmond Chuah1, Noor Al Khonaizi1, Shona Tormey1, Anne Merrigan1, Juliette Buckley1, Chwanrow Baban1, Lorraine Walsh2

1Department of Breast Surgery, University Hospital Limerick, Limerick, Ireland; 2Department of Radiation Oncology, University Hospital Limerick, Limerick, Ireland

Background: Axillary lymph node dissection (ALND) remains the gold standard management for patients with positive sentinel lymph node (SLN) biopsy. Due to the significant morbidity in performing ALND, there has been a shift in paradigm towards de-escalation of axillary surgery. Moreover, fewer than 70% of patients with positive SLNs have additional non-sentinel lymph node (non-SLN) metastases in ALND. Predictive tools notably nomograms developed by Memorial Sloan Kettering Cancer Centre (MSKCC) and MD Anderson Cancer Centre (MDACC) could help predict the odds of non-SLN involvement. This allows safe omission of ALND in patients with breast cancer that fulfil a low-risk cancer profile. This study aims to assess the utility of nomograms from MSKCC and MDACC on the Irish patient cohort.

Methods: A retrospective study of a prospectively collected data was conducted using the breast cancer database at a tertiary university hospital. Patients with breast cancer and positive SLN biopsy who subsequently underwent ALND between 2014 and 2023 were included. Clinicopathological data such as tumour type, lymphovascular invasion, SLN positivity and the size of SLN metastases were analysed. The MSKCC and MDACC nomograms were utilised to estimate the risk of non-SLN metastases based on above clinic-pathological data. The predicted positivity rates of non-SLN metastases are compared to actual ALND yield.

Results: The outcome of this study can guide the selection of nomogram for clinical practise in the Irish cohort. Moreover, results from this 10-year patient cohort can further suggest a safe cut-off value for omission of axillary surgery in our local clinical practise.

Conclusions: The nomogram developed has promising predictive capacity.

Keywords: Axillary lymph node dissection (ALND); breast cancer; nomogram; non-sentinel lymph node metastases; sentinel lymph node

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab051
Cite this abstract as: O’Doherty A, Chuah YHD, Al Khonaizi N, Tormey S, Merrigan A, Buckley J, Baban C, Walsh L. AB051. SOH25_AB_129. One less surgery: predicting non-sentinel lymph node metastasis in patients with breast cancer and positive sentinel node biopsy using nomogram in the Irish cohort. Mesentery Peritoneum 2025;9:AB051.

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