Comparison of the effectiveness of nomograms used to predict sentinel lymph node involvement preoperatively in breast cancer patients and clinical and PET/CT findings with laboratory parameters

Background: The aim of the study was to compare the efficacy of nomograms used to predict preoperative sentinel lymph node involvement in patients diagnosed with breast cancer, and clinical findings, PET/CT imaging and laboratory parameters. Material and Methods: Female patients who were diagnosed with histopathological breast cancer in Bolu Abant İzzet Baysal University Medical Faculty Hospital General Surgery Clinic between 2015 and 2020 were retrospectively screened. Patients who did not have distant metastases at the time of diagnosis, had ultrasonographic imaging results, had PET/CT scans, had sentinel lymph node biopsy, and whose information could be fully accessed from the hospital computer database were included in the study. Patients who underwent sentinel lymph node biopsy after neoadjuvant therapy were excluded from the study. Laboratory parameters (PLR, NLR, LMR and MPR) were calculated from the complete blood count taken within 24 hours before surgery. MSKCC method was used from nomograms. The patients were grouped as sentinel lymph node positive and negative. All obtained data were compared with statistical tests. Results: A total of 48 patients were included in the study due to the coronavirus (COVID-19) pandemic, which is effective worldwide. A statistically significant correlation was found between physical examination, USG and PET/CT findings in terms of axilla positivity and pathology result (p<0.001, p=0.005 and p=0.002). The SUVmax value of the axilla was found to be statistically significantly higher in patients with positive SLNB results than in patients with negative results (2.90±3.46 vs. 0.66±1.86, p=0.004). Although the rates of PLR, NLR, LMR and MPR among the laboratory parameters were higher in the SLNB positive group, they were not statistically significant (p=0.683, p=0.6, p=0.948 and p=0.354). Although MSKCC nomogram values were higher in showing SLNB positivity, these results were not statistically significant (p=0.243). Conclusion: Axillary involvement in patients diagnosed with breast cancer is still one of the areas that clinicians are most interested in. Nowadays, it is important to evaluate the axilla with easier and less invasive methods in breast cancer, in which the minimally invasive surgical strategy is replaced by radical surgery. It was also seen in our study that clinical, laboratory, PET/CT imaging and nomograms alone have limited predictions about axillary involvement. However, we think that a new algorithm combining all of these will give better results in this regard. Keywords: laboratory parameters, breast cancer, nomogram, PET/CT, sentinel lymph node.