Additional Nodal Metastasis Nomogram
Why Use
Many patients with a positive SLN will not have residual disease. This tool estimates the probability of additional non-SLN metastases, which may inform whether axillary lymph node dissection is warranted.
When to Use
Use in patients with invasive breast cancer with a positive sentinel lymph node (SLN) when deciding next steps in management.
Formula
Pearls / Pitfalls
Pathology techniques and systemic therapy have evolved since this tool was developed, which can shift baseline risks and affect calibration in modern cohorts. External validations show moderate discrimination and variable calibration; reliability of nomograms for clinical use has been questioned.
Advice
Use results with multidisciplinary input to determine appropriate axillary management, which may include: Adjuvant chemotherapy. Regional radiotherapy. Targeted axillary dissection. Axillary lymph node dissection. Please review your local medical society guidelines for additional management recommendations, such as the American Society of Breast Surgeons and the National Comprehensive Cancer Network .