"As our population ages, women over the age of 70
will continue to form a significant proportion of our patient
population. These patients often present unique challenges to
clinicians: they frequently have relatively favorable hormone
receptor-positive breast cancers, yet they may have other
comorbidities that influence treatment options. We sought to
determine whether a subset of these patients could be predicted
to be node-negative, and could therefore be spared axillary node
evaluation. We found that patient age, tumor size, and
lymphovascular invasion were independent predictors of lymph
node status in this population. Based on these factors, we
created and validated a clinical prediction model to determine
the likelihood of lymph node metastases, and defined a
population in whom the risk of lymph node metastases is low (less
than/equal to 5%). While most patients will undergo sentinel
lymph node biopsy, for patients in whom comorbidities may imply
significant risk of this procedure, our model may aid clinicians
in predicting risk of lymph node metastases" (Comment
on:
Chagpar AB et al.: "Can sentinel node biopsy be avoided in some
elderly breast cancer patients?",
Ann Surg.
2009; 249(3):455-60)
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