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Breast Cancer Nomogram : Disclaimer

The prediction tools (also known as prognostic nomograms) available on Memorial Sloan Kettering Cancer Center's ("MSK") website use algorithms or mathematical formulas to estimate the probability of a particular outcome. They are for general health information only. The tools have not been reviewed or approved by any regulatory agencies in the United States or elsewhere, and are not intended for use as a medical device. The tools are not to be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem. Users of the prediction tools should not rely on any resulting information for their own health problems. Outputs from these tools are estimates based on survival models built from databases of large numbers of patients. The predictions suggested by these tools may not apply to a given individual. A licensed clinician should always be consulted for any health problem(s) or medical condition(s).

Users agree to use the prediction tools for educational and/or research purposes only, and not for any commercial purposes, including the distribution, licensing, or sale of their content to any other person or entity, whether alone or in combination with other materials, or the incorporation of any of the prediction tools into any commercial product.

MSK makes no warranties, nor express or implied representations whatsoever, regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced in the prediction tools. MSK does not assume any risk whatsoever for use of the prediction tools or the information contained therein. As health-related information changes frequently, information contained in the prediction tools may be outdated, incomplete, or incorrect.

Use of the prediction tools does not create an express or implied physician-patient relationship. MSK does not endorse or claim validity for the prediction tools found on MSK's website. The activities and products of MSK and its developers and agents (collectively MSK) are not endorsed by past, present, or future employers. MSK does not record specific prediction tool user information and does not contact users of the prediction tools.

Users are advised to consult with a physician or other professional healthcare provider prior to making any decisions, or undertaking any actions or not undertaking any actions related to any healthcare problem or issue that users might have at any time, now or in the future. In using the prediction tools, users agree that neither MSK nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to the use of any information resulting from the prediction tools on MSK's website.

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Breast Cancer Nomogram: Breast Additional Non SLN Metastases

This nomogram can be used to help newly diagnosed breast cancer patients assess the likelihood that their breast cancer has spread to the sentinel lymph nodes.

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Was a frozen section analysis performed during pathological examination? This does not have to be the method that detected the cancer in the sentinel lymph nodes, but it is necessary to know as a variable for this calculator.
Size of the primary tumor, in centimeters.
 (0.1 to 9.0 cm)
Indicate if tumor type is ductal or lobular, as noted in the pathology report. If ductal, indicate the nuclear grade -- I: slight or no variation in the size and shape of the nucleus; II: moderate variation in the size and shape of the nucleus; III: marked variation in the size and shape of the nucleus.
Indicate the number of sentinel lymph nodes found to have cancer when biopsied.
 (1 to 7 nodes)
Select the method used to detect cancer spread to the sentinel lymph nodes.
Indicate the number of sentinel lymph nodes that were found not to have cancer when biopsied.
 (0 to 14 nodes)
Check box if one or more tumor cells were found in blood or lymphatic vessels.
Check box if patient has cancer cells that have separated from the main tumor mass.
Select YES if breast cancer cells tested positive for estrogen receptors.

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Predicted Probability of Spread to Additional Lymph Nodes

Using information commonly available to a breast cancer patient’s surgeon, this nomogram can accurately calculate the likelihood that a breast cancer that has spread to the sentinel lymph nodes has also spread to additional lymph nodes under the arm.

Supporting Publications

Specht MC, Kattan MW, Gonen M, Fey J, Van Zee KJ. Predicting nonsentinel node status after positive sentinel lymph biopsy for breast cancer: clinicians versus nomogram. Ann Surg Oncol. 2005 Aug;12(8):654-9.
A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Van Zee KJ, Manasseh DM, Bevilacqua JL, Boolbol SK, Fey JV, Tan LK, Borgen PI, Cody HS 3rd, Kattan. Ann Surg Oncol. 2003 Dec;10(10):1140-51.