Post by Clinical Surgical Oncology

HIGHLIGHT IN CSO | MSKCC nomogram-guided SLNB omission achieves 94.2% NPV — the highest among all de-escalation strategies evaluated 🌸 Less surgery, same safety? In 1080 early breast cancer patients, a nomogram-guided strategy delivered the best balance between sparing patients from sentinel node biopsy and maintaining diagnostic accuracy. 📊 Head-to-head comparison at a glance: • MSKCC ≤23%: 29% spared, FNR 9.6%, NPV 94.2% ⭐ • SOUND trial: 46% spared, FNR 29.4%, NPV 88.8% • INSEMA trial: 67% spared, FNR 53.5%, NPV 86.2% • ASCO 2021: 15% spared, FNR 6.9%, NPV 92.0% 🧩 The MSKCC nomogram (AUC 0.77) offers something unique: continuous, individualised risk estimation rather than binary inclusion rules. This flexibility allows clinicians to adjust thresholds based on clinical intent — whether the goal is omitting SLNB or guiding treatment decisions. 🌼 The take-home: personalised risk models may offer a flexible, risk-adapted middle ground between aggressive de-escalation and conservative approaches. Prospective validation with long-term follow-up is the next step. 🔗 DOI: https://lnkd.in/gcD6hcQM 🔗 Full text: https://lnkd.in/gTgybm2B Maroondah Hospital - Eastern Health Christobel Saunders Shomik Sengupta European Society of Surgical Oncology (ESSO) American Society of Clinical Oncology (ASCO) The American Society of Breast Surgeons #ClinicalSurgicalOncology #CSO #BreastCancer #SentinelNode #AxillaryDeEscalation #PrecisionMedicine