{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:51:44Z","timestamp":1775267504018,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,4,4]],"date-time":"2014-04-04T00:00:00Z","timestamp":1396569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:p>Screening mammography improved early detection of breast cancer and since then, the percentage of patients with node involvement is declining. Sentinel lymph node biopsy (<jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content>), although helpful in the diagnostic armamentarium of these patients, has consequential limitations. In these patients, moreover, lymphatic invasion (<jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>) is of utmost importance to determine the risk of local recurrence. To find an adjuvant histologic approach to assist in pre\u2010operative analysis of the patient's risk for having <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content> and thus sentinel \u00b1 non\u2010sentinel axillary lymph node metastasis, one hundred and twenty patients with early invasive duct carcinoma without axillary lymph node metastasis were evaluated. Logistic regression predictive models were built from 80 patients and validated in the remaining 40 patients. The final stepwise multi\u2010regression analysis identified four sensitive models. In the validation group, model 1 [applicable to tumors grade 3 having micropapillary differentiation (<jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>)] correctly identified 92.31% of patients with <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content> and confirmed <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content> [positive predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>)\u00a0=\u00a083%], but with moderate sensitivity. Model 2 [applicable to tumors without <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>], model 3 [applicable to tumors grade 1\/2], and model 4 [applicable to tumors grade 1\/2 having no <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>] all had moderate <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content> and a high negative predictive value (<jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>) rendering these models reliable negative tests. However, as they had high sensitivity, positive results confirm the presence of <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>. Patient with tumors grade 3 and <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> might need <jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content> and\/or axillary lymph node dissection (<jats:styled-content style=\"fixed-case\">ALND<\/jats:styled-content>). Patients having tumors grade 1\/2, size &lt;2\u00a0cm, and no <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> nor extensive retraction artifact, <jats:styled-content style=\"fixed-case\">SLNB<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">ALND<\/jats:styled-content> could be omitted. In tumors grade 1\/2 (model 2) and those without <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> (model 3), the proposed models are reliable negative tests rather than a definitive positive one.<\/jats:p>","DOI":"10.1111\/apm.12256","type":"journal-article","created":{"date-parts":[[2014,4,4]],"date-time":"2014-04-04T07:35:50Z","timestamp":1396596950000},"page":"1032-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Histolopathologic approach to direct the management of the axilla in early breast cancer patients"],"prefix":"10.1111","volume":"122","author":[{"given":"Rola M","family":"Farid","sequence":"first","affiliation":[{"name":"Department of Pathology Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naglaa S","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Pathology Faculty of Medicine 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