• Mehmet Kubat and Zülfikar Karabulut.
• J Coll Physicians Surg Pak. 2020 Jun 1; 30 (6): 595-600.

ObjectiveTo investigate the effectiveness of tumor volume dependent mean diameter (Rmax) in determining axillary lymph node metastasis positivity instead of the largest diameter (Dmax) in breast cancer.Study DesignDescriptive study.Place And Duration Of StudyDepartment of General Surgery, Ankara Training and Reseach Hospital, Turkey, from January 2009 to December 2018.MethodologyPatients with breast cancer, who underwent modified radical mastectomy and lumpectomy and axillary lymph node dissection due to invasive carcinoma, included in this study. Approximate vTm was calculated from the obtained tumor specimen dimensions using ellipsoid volume formula. From the sphere volume formula, Rmax, which gives the same vTm value, was reversely calculated. Efficacy and usability of Rmax value were evaluated on nomograms that are available online; and are used most frequently owing to its ease of use.ResultsIn 305 patients, mean Dmax was 3.4 ±1.8 cm, mean vTm was 17.9 ±35.9 cm3, and mean Rmax was 2.6 ±1.4 cm. For the distinction of ALNM positive and negative patients, Dmax significant [Area Under Curve (AUC) 0.709], Rmax significant [AUC 0.748] and vTm significant [AUC 0.748] efficacy was considered.ConclusionWhen the relationships of Dmax and vTm with ALNM were compared in breast cancer cases, the efficacy of vTm is higher. It was found that vTm and Rmax can be used instead of Dmax. The relation of Rmax parameter with ALNM was found to be higher. When Rmax was used in nomogram samples, which are currently used in predicting ALNM positivity, it increased nomogram efficacy. Key Words: Breast neoplasm, Tumor burden, Tumor volume, Tumor diameter, Lymphatic metastasis.

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