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P 116

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  1. P 116 Nomogramwith total tumoral load as a novel factor to predict axillary metastasis in breast cancer Isabel T Rubio, MD1,9*, Martín Espinosa-Bravo, MD1, Begoña Vieites, MD2, FelipVilardell, MD3, José R. Antúnez , MD4, Magdalena Sancho de Salas, MD5, Julio J. Delgado-Sánchez, MD6, Willy Pinto, MD7, Francisco Gozalbo, MD8, V. Peg, MD11Breast Cancer Center at Valld´HebronUniversity Hospital, Barcelona, 2Pathology Department Hospital Virgen del Rocío, Sevilla, 3Pathology Department Hospital Arnau de Vilanova, Lérida, 4Pathology Department Complejo Hospitalario Universitario de Santiago de Compostela, 5Pathology Department Hospital Clínico de Salamanca, 6Pathology Department Hospital 12 de Octubre, Madrid, 7Pathology Department Hospital Dr. Negrín, Gran Canaria, 8Instituto Valenciano de Oncología, Barcelona, 9SOLTI BreastCancerResearchGroup, Barcelona, Spain. AIMS AIMS RESULTS AIMS Several models have been developed to predict non sentinel node (SLN) metastasis in patients with a positive SLN. However, the lack of accepted guidelines for SLN analysis results in a great heterogeneity in disease assessment. Intraoperative SLN assessed by one step nucleic acid amplification (OSNA) has been validated as an accurate method for detection of SLN metastasis compared to conventional histological examination. It have been reported that the total tumoral load in the SLNs assessed by OSNA is a predictive factor for additional non SLN metastasis in the axillary lymph node dissection (ALND). Based on the data generated on this multicenter study, we developed a nomogram that would allow predicting patient´s risk of additionalnonSLN metastasis including parameters not previously considered. On multivariate logistic regression analysis, tumor size, number of affected SLN, Her2 overexpression, LIV, and total tumoral load were each associated with the likelihood of additional non SLN metastasis (p < 0.05). A nomogram was created with these variables and the overall predictive accuracy of the nomogram, as measured by the AUC was 0.7552 (IC95% de 0,7159 a 0.7945). The nomogram was well calibrated with no evidence of a difference between the predicted and the observed probabilities (p > 0.999). AIMS METHODS Six hundred and ninety seven consecutive patients with clinically and ultrasonographically node-negative cT1-3 invasive breast cancer who had undergone intraoperative SLN evaluation by OSNA were recruited. Pathologic features of the primary tumor and SLN metastases, including total tumoral load (TTL) were collected. TTL was defined as the amount of CK19 mRNA copies (copies/μL) in all positive SLNs obtained by OSNA, The performance of the model was evaluated in the training set in terms of discrimination and calibration. AIMS CONCLUSIONS TTL assessed by OSNA is a new predictive factor of non SLN metastasis in breast cancer patients with positive SLNs. This novel, accurate, and discriminating nomogram may significantly help clinicians to make decisions about ALND. Moreover, the standarization of pathologic assessment by OSNA may help to achieve interinstitutionalreproductibility among nomograms.

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