The appropriate axillary procedure after a positive sentinel node in breast cancer patients: the “Hôpital Tenon” score revisited: A two-institution study

• I. Barco ^[3] ; A. García-Fernández ^[3] ; C. Chabrera ^[4] ; M. Fraile ^[3] ; E. Vallejo ^[3] ; J. M. Lain ^[1] ; J. Deu ^[3] ; S. González ^[3] ; C. González ^[3] ; E. Veloso ^[3] ; J. Torres ^[3] ; M. Torras ^[3] ; L. Cirera ^[3] ; A. Pessarrodona ^[3] ; N. Giménez ^[3] ; M. García-Font ^[2]
  1. [1] Hospital de Terrassa

     Hospital de Terrassa

     Barcelona, España

     
  2. [2] Universitat Internacional de Catalunya

     Universitat Internacional de Catalunya

     Barcelona, España

     
  3. [3] Hospital Universitario de Mútua Terrassa, España
  4. [4] TecnoCampus Mataró-Maresme, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 18, Nº. 11 (November 2016), 2016, págs. 1098-1105
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Introduction Until recently, completion ALND has been considered the standard of care after a positive SN in breast cancer patients. However, most patients will not display further axillary involvement. The Tenon score is a simple nomogram that can be used intraoperatively to avoid completion ALND in low-risk patients. We aimed at validating the Tenon score on a SN-positive patient sample that had been preoperatively selected using axillary US examination.

    Patients and method We used a retrospective analysis of our bicentric database that included 246 breast cancer patients with a positive SN. We calculated sensitivity, specificity, as well as positive and negative predictive values for each cut-off point. ROCs were constructed and corresponding AUC values were calculated as a measure of discriminative capacity.

    Results At least one non-SN was positive in 52 patients (21.1 %). 118 patients (48 %) had a score up to 5. Among them, three had at least one positive non-SN. NPV was 97.5 %. Using that threshold, the ROCs analysis showed an AUC of 0.822 (95 % CI 0.764–0.880).

    Conclusion Use of preoperative axillary US examination led to a modification of the proposed Tenon cut-off value from 3.5 to 5 to attain good predictive power for non-SN status. Straightforward intraoperative use of the Tenon score may be considered an advantage over other available nomograms.