mskcc_additional_nodal_metastasis: MSKCC Additional Nodal Metastasis Nomogram

In cliot: Clinical Indices and Outcomes Tools

MSKCC Additional Nodal Metastasis Nomogram

Description

Calculates the probability of having additional non-sentinel lymph node (NSLN) metastases in breast cancer patients who have a positive sentinel lymph node (SLN). This function implements the logistic regression model from the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram developed by Van Zee et al. It uses pathologic variables to predict the likelihood of residual disease in the axilla.

Usage

mskcc_additional_nodal_metastasis(frozen_section_pos, method_detection,
                                  tumor_size_cm, lvi, multifocality,
                                  num_pos_sln, num_neg_sln)

Arguments

frozen_section_pos	Numeric (0 or 1). Was the sentinel node metastasis identified on intraoperative frozen section? (1 = Yes, 0 = No).
method_detection	String. Method of detection if frozen section was negative or not done. "routine": Routine H&E staining (associated with higher risk than specialized detection). "serial": Serial H&E or Immunohistochemistry (IHC).
tumor_size_cm	Numeric. Pathologic tumor size in centimeters.
lvi	Numeric (0 or 1). Lymphovascular Invasion present? (1 = Yes, 0 = No).
multifocality	Numeric (0 or 1). Multifocality present? (1 = Yes, 0 = No).
num_pos_sln	Numeric. Number of positive sentinel lymph nodes found.
num_neg_sln	Numeric. Number of negative sentinel lymph nodes found.

Value

A list containing:

Probability_Non_SLN_Metastasis	The estimated percentage probability of finding additional metastasis in the non-sentinel nodes.
Inputs	A list of the processed input variables.

References

Van Zee KJ, Manasseh DM, Bevilacqua JL, et al. A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Ann Surg Oncol. 2003;10(10):1140-1151. doi:10.1245/aso.2003.03.015

Examples

# Example 1: High Risk
# Frozen section positive, 2.5cm tumor, LVI positive, 2 Pos SLN, 0 Neg SLN
mskcc_additional_nodal_metastasis(1, "n/a", 2.5, 1, 0, 2, 0)

# Example 2: Low Risk
# Routine H&E, 1.2cm tumor, No LVI, 1 Pos SLN, 3 Neg SLN
mskcc_additional_nodal_metastasis(0, "routine", 1.2, 0, 0, 1, 3)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.