Our breast cancer nomograms are online prediction tools designed to estimate elements of breast cancer risk for an individual patient. Physicians at MSK have developed three nomograms that can be used to assess different types of breast cancer risk.
All results from these tools should be discussed with a physician and understood in the context of each patient’s program of care. Results produced by these tools are based on data from patients treated at MSK, a large research institution with surgeons who perform a high volume of breast cancer procedures.
Sentinel Lymph Node Metastasis
Our sentinel lymph node metastasis nomogram is a tool designed for patients newly diagnosed with breast cancer to estimate the likelihood that cancer has spread to the sentinel lymph nodes (the first nodes to which the cancer would spread in the breast and underarm region). It predicts any finding of cancer cells in the sentinel lymph nodes, including cells found by immunohistochemical staining only, a finding currently staged as pN0(+). This nomogram is not appropriate for patients who have already undergone neoadjuvant therapy (treatment such as chemotherapy, hormone therapy, or other drugs given before surgery). It is also not a substitute for a sentinel lymph node biopsy. This tool is intended for use in consultation with a physician.
Additional Nodal Metastases
Our additional nodal metastases nomogram is a tool designed to estimate the likelihood that cancer has spread beyond the sentinel lymph nodes (the first nodes to which the cancer would spread in the breast and underarm region) to other non-sentinel nodes under the arm. It is appropriate for individual patients with primary invasive breast cancer that has already spread to the sentinel lymph nodes, but is not appropriate for patients in whom enlarged metastatic nodes could be felt on physical examination. It is also not appropriate for patients who have already had systemic therapy (chemotherapy or hormone therapy) or radiation therapy for this breast cancer. This tool has been externally validated at more than 20 institutions across Europe and North America (see Supporting Publications) and the original study was recognized as the most cited paper in 2007 by the Annals of Surgical Oncology.
Probability of Recurrence After Breast-Conserving Surgery for Ductal Carcinoma In Situ
Our ductal carcinoma in situ (DCIS) nomogram is a tool designed to estimate the likelihood that a patient will develop invasive cancer or recurrent DCIS in the same breast over the 5 years and 10 years after undergoing breast-conserving surgery for DCIS. Recurrence is the return of a cancer -- in this case, as either DCIS or as invasive cancer -- after a period during which it could not be detected. Risk of recurrence is a key factor in treatment planning. In consultation with a physician, patients can use their results from this nomogram to make decisions regarding various treatment options, such as radiation therapy and anti-estrogen therapy.