{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:33:41Z","timestamp":1782491621588,"version":"3.54.5"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:00:00Z","timestamp":1612569600000},"content-version":"vor","delay-in-days":1299,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Axillary staging in patients with breast cancer and clinically node-negative disease is performed by sentinel node biopsy (SLNB). The aim of this study was to integrate feasible preoperative variables into nomograms to guide clinicians in stratifying treatment options into no axillary staging for patients with non-metastatic disease (N0), SLNB for those with one or two metastases, and axillary lymph node dissection (ALND) for patients with three or more metastases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients presenting to Sk\u00e5ne University Hospital, Lund, with breast cancer were included in a prospectively maintained registry between January 2009 and December 2012. Those with a preoperative diagnosis of nodal metastases were excluded. Patients with data on hormone receptor status, human epidermal growth factor receptor 2 and Ki-67 expression were included to allow grouping into surrogate molecular subtypes. Based on logistic regression analyses, nomograms summarizing the strength of the associations between the predictors and each nodal status endpoint were developed. Predictive performance was assessed using the area under the receiver operating characteristic (ROC) curve. Bootstrap resampling was performed for internal validation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 692 patients eligible for analysis, 248 were diagnosed with node-positive disease. Molecular subtype, age, mode of detection, tumour size, multifocality and vascular invasion were identified as predictors of any nodal disease. Nomograms that included these predictors demonstrated good predictive abilities, and comparable performances in the internal validation; the area under the ROC curve was 0\u00b774 for N0versus any lymph node metastasis, 0\u00b770 for one or two involved nodes versus N0, and 0\u00b781 for at least three nodes versus two or fewer metastatic nodes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The nomograms presented facilitate preoperative decision-making regarding the extent of axillary surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10583","type":"journal-article","created":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T13:09:51Z","timestamp":1500383391000},"page":"1494-1505","source":"Crossref","is-referenced-by-count":61,"title":["Nomograms for preoperative prediction of axillary nodal status in breast cancer"],"prefix":"10.1093","volume":"104","author":[{"given":"L","family":"Dihge","sequence":"first","affiliation":[{"name":"Departments of Surgery, Clinical Sciences Lund, Lund University, Lund, Sweden"},{"name":"Department of Plastic and Reconstructive Surgery, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P-O","family":"Bendahl","sequence":"additional","affiliation":[{"name":"Departments of Oncology and Pathology, Clinical Sciences Lund, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7515-3130","authenticated-orcid":false,"given":"L","family":"Ryd\u00e9n","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Clinical Sciences Lund, Lund University, Lund, Sweden"},{"name":"Department of Surgery, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,7,18]]},"reference":[{"key":"2021020617275349600_bjs10583-bib-0001","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1056\/NEJMoa012782","article-title":"A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer","volume":"349","author":"Veronesi","year":"2003","journal-title":"N Engl J Med"},{"key":"2021020617275349600_bjs10583-bib-0002","doi-asserted-by":"crossref","first-page":"7703","DOI":"10.1200\/JCO.2005.08.001","article-title":"American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer","volume":"23","author":"Lyman","year":"2005","journal-title":"J Clin Oncol"},{"key":"2021020617275349600_bjs10583-bib-0003","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1001\/jama.2011.90","article-title":"Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial","volume":"305","author":"Giuliano","year":"2011","journal-title":"JAMA"},{"key":"2021020617275349600_bjs10583-bib-0004","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/SLA.0000000000001863","article-title":"Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: long-term follow-up from the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 randomized trial","volume":"264","author":"Giuliano","year":"2016","journal-title":"Ann Surg"},{"key":"2021020617275349600_bjs10583-bib-0005","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1470-2045(13)70035-4","article-title":"Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial","volume":"14","author":"Galimberti","year":"2013","journal-title":"Lancet Oncol"},{"key":"2021020617275349600_bjs10583-bib-0006","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S1470-2045(14)70460-7","article-title":"Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial","volume":"15","author":"Donker","year":"2014","journal-title":"Lancet Oncol"},{"key":"2021020617275349600_bjs10583-bib-0007","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1001\/archsurg.1996.01430150079015","article-title":"The new era in breast cancer. 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