{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:25:22Z","timestamp":1767374722156},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T00:00:00Z","timestamp":1439164800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Netherlands Organization for Scientific Research","award":["917.11.383"],"award-info":[{"award-number":["917.11.383"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>This study was conducted to evaluate the performance of available tools predicting non\u2010sentinel lymph node (non\u2010SLN) status in women with SLN positive breast cancer and to see if they can be safely used in everyday clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of 220 women with breast cancer who underwent a SLN biopsy at the M\u00e1xima Medical Centre between 2000\u20132008 were analysed. Tools evaluated were: the models from Memorial Sloan Kettering Cancer Centre, Stanford, Mayo, Cambridge, Gur, and MOU, and the scores from Saidi, Tenon, and MDA. Model performance was assessed using calibration, discrimination and Nagelkerke's explained variation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The MSKCC nomogram showed best overall performance with best discrimination (AUC 0.69), second best calibration, and highest explained variation (31%). The 10% low risk threshold led to defining only 22% (38\/176) of the women as being low risk while in fact 66% (116\/176) were non\u2010SLN negative. The false negative rate was 13% (5\/38).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Current models for predicting non\u2010SLN metastases in SLN positive breast cancer are not yet ready for implementation in general practice. Further research efforts should improve model performance in selecting patients or perhaps find a role in support in the paradigm shift to a \u201ctreat none unless\u201d approach. <jats:italic>J. Surg. Oncol. 2015 111:133\u2013138<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23992","type":"journal-article","created":{"date-parts":[[2015,8,10]],"date-time":"2015-08-10T13:03:06Z","timestamp":1439211786000},"page":"133-138","source":"Crossref","is-referenced-by-count":15,"title":["A head to head comparison of nine tools predicting non\u2010sentinel lymph node status in sentinel node positive breast cancer women"],"prefix":"10.1002","volume":"112","author":[{"given":"Ingrid","family":"van den Hoven","sequence":"first","affiliation":[{"name":"Department of Surgery M\u00e1xima Medical Center Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gert","family":"Kuijt","sequence":"additional","affiliation":[{"name":"Department of Surgery M\u00e1xima Medical Center Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudi","family":"Roumen","sequence":"additional","affiliation":[{"name":"Department of Surgery M\u00e1xima Medical Center Veldhoven The Netherlands"},{"name":"Maastricht University Medical Center GROW\u2010school for Oncology and Developmental Biology Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adri","family":"Voogd","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center GROW\u2010school for Oncology and Developmental Biology Maastricht The Netherlands"},{"name":"Department of Research Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewout W.","family":"Steyerberg","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Vergouwe","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199904000-00013"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.05.020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.03.015"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-8-66"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.06.008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5943"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2009.05.007"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12253-009-9177-6"},{"key":"e_1_2_7_10_1","first-page":"105","article-title":"Nonsentinel lymph node status after positive sentinel lymph node biopsy in early breast cancer","author":"Saidi RF","year":"2004","journal-title":"Am Surg"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-004-5781-z"},{"key":"e_1_2_7_12_1","first-page":"432","article-title":"Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: The American College of Surgeons Oncology Group Z 0011 randomized trial","author":"Giuliano AE","year":"2010","journal-title":"Ann Surg"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70035-4"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7186"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-007-9884-1"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-012-1991-y"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.7418"},{"key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1177\/000313480407001119","article-title":"Use and limitations of a nomogram predicting the likelihood of non\u2010sentinel node involvement after a positive sentinel node biopsy in breast cancer patients","author":"Kocsis L","year":"2004","journal-title":"Am Surg"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.03.078"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.09.031"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.07.022"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.04.011"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2005.06.037"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20835"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0359-y"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-012-2360-6"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2009.12.004"},{"key":"e_1_2_7_28_1","unstructured":"Richtlijn mammacarcinoom 2.0 [Internet]. []. Available from:http:\/\/www.oncoline.nl\/mammacarcinoom"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70460-7"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2012.04.018"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2012.04.016"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4071-1"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.9479"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.23992","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.23992","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T15:21:14Z","timestamp":1696346474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.23992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1002\/jso.23992"],"URL":"https:\/\/doi.org\/10.1002\/jso.23992","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8]]}}}