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Breast Cancer Nomogram : Disclaimer

The prediction tools, also known as prognostic nomograms, located on the MSKCC Web site are for general health information only. The prediction 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 information provided by the prediction tools for their own health problems. Questions should be addressed to your own physician or other healthcare provider.

MSKCC 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. MSKCC does not assume any risk whatsoever for your use of the prediction tools or the information contained herein. Health related information changes frequently and therefore information contained in the prediction tools may be outdated, incomplete or incorrect.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. MSKCC does not endorse or claim validity for the prediction tools found on the MSKCC Web site. The activities and products of MSKCC and its developers and agents (collectively MSKCC) are not endorsed by our past, present, or future employers. MSKCC does not record specific prediction tool user information and does not contact users of the prediction tools.

You are hereby 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 you might have at any time, now or in the future. In using the prediction tools, you agree that neither MSKCC 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 your use of any information presented in the prediction tools.

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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.