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Patients with metastases in four or more axillary lymph nodes (≥4+ALN) represent a subset of patients with breast cancer who are at increased risk of local recurrence and who benefit from postmastectomy radiation. Risk prediction models designed to identify such patients have been published by Rivers et al., Chagpar et al., and Katz et al. We sought to evaluate and compare the performance of these models in an independent patient population.

Predicting Four or More Metastatic Axillary Lymph Nodes in Patients with Sentinel Node-Positive Breast Cancer: Assessment of Existent Risk Scores