An axillary score (Barranger Score) to predict nonsentinel node metastasis in breast cancer patients with positive sentinel node

To the Editor: In the last issue of the American Journal of Surgery, Cripe et al [1] contribute to the debate around the examination factors potentially predictive of axillary nonsentinel lymph node (non-SLN) status in patients with sentinel lymph node (SLN) involvement and validate the Van Zee nomogram [2]. Using multivariate analysis, we showed a significant association with non-SLN status of histologic primary tumor size, SLN macrometastasis, and the ratio of the number of metastatic SLNs to the total number SLNs removed.