Validation of MSKCC nomogram in predicting sentinel lymph node metastasis of breast cancer        CHEN Jia-ying*, CHEN Jia-jian, YANG Ben-long, et al. *Department of Breast Surgery, Cancer Hospital/Cancer Institute, Breast Cancer Institute, Fudan University,Shanghai 200032, China
Corresponding author: WU Jiong, E-mail:wujiong1122@.vip.sina.com
Abstract    Objective    To validate the clinical value of the MSKCC nomogram that predicts the presence of sentinel lymph node (SLN) metastasis in Chinese early-stage breast cancer population. Methods    Data were collected from 524 patients with successful SLN biopsy who were treated during 2005 March to 2009 October. Touch imprint cytology (TIC) and serial section with H&E staining were performed routinely on each sentinel node. MSKCC nomogram was used to estimate probability of SLN involvement and compared with actual probability after grouping into deciles. A ROC curve was drawn and predictive accuracy was assessed by calculating the area under the receiver-operating characteristic (ROC) curve. Results    It was shown that age, tumor size, histological grade and lymphovascular invasion was correlated with the probability of SLN metastasis by univariate analysis. By Multivariate analysis, tumor size and lymphovascular invasion were identified as independent predictors of SLN metastasis. The odds ratio(OR )of the lymphovascular invasion was 9.462（95% CI 5.551-16.130）while OR of tumor size was 1.429（95% CI 1.142-1.788）. The trend of actual probability in various decile groups was comparable to the predicted probability. The area under the ROC curve was 0.757 as compared to 0.754 in the original population. Conclusion    The MSKCC nomogram that predicts metastasis of breast cancer in the sentinel lymph node performed good in a Chinese breast cancer population. It could provide a clinical accessory in the preoperative discussion of the patients.