4.1 Article

Axillary Lymph Node Involvement in Breast Cancer: A Random Walk Model of Tumor Burden

Journal

CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 11, Issue 11, Pages -

Publisher

SPRINGERNATURE
DOI: 10.7759/cureus.6249

Keywords

breast neoplasms; prognostic factors; lymph node ratio; auto-correlation; random walk; drift; recursive model

Ask authors/readers for more resources

We reinvestigate the relationship between axillary lymph node involvement in breast cancer and the overall risk of death. Patients were women from the Surveillance, Epidemiology, and End Results (SEER) program, aged between 50 and 65 years, presenting a first primary T1-T2 (tumor size <= 5 cm), node-positive, non-metastasized unilateral breast carcinoma, diagnosed from 1988 to 1997, treated with mastectomy without radiotherapy. Hazard ratios (HRs) were computed at each percentage of involved nodes using the proportional hazards model, adjusting for the patient's demographic and tumor characteristics. The pattern of the hazard ratios was examined using serial correlations. Significance testing used the portmanteau test. Based on 4,387 records available for analysis, the relation between adjusted mortality and axillary lymph node involvement was modeled as H-t - Ht-1 = mu + a(t), where t is the percentage of involved nodes, H-t is the mortality hazard ratio at the percentage t, mu is a constant, and a(t) is white noise. The constant mu was estimated at 0.020, corresponding to a 2% increment in the mortality hazard ratio per 1% increase in the percentage of positive nodes. The model was considered acceptable by the portmanteau test (P=0.205). We conclude that the effect of the tumor burden might be expressed as a random walk difference model, relating the mortality hazard ratio with the percentage of involved nodes. We will use the model to explore how treatments affect the course of the disease.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.1
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available