The KATS status is an as-yet-unpublished attempt at using some fairly objective parameters to determine the odds that a newly diagnosed case of invasive ductal adenocarcinoma will have one or more positive axillary lymph nodes. Axillary lymph node dissection (or sentinel lymph node biopsy [SLN]) provides one of the most valuable bits of staging data: whether any nodes are positive for metastatic cancer (ALN+) or negative (ALN-). But, there can be negative consequences to surgically disturbing the axillary (arm-pit area) area. The KATS grouping was mentioned to us at a conference in Palm Springs, California, 9/00. The originator is Cary S. Kaufman, M. D., breast surgeon at the Bellingham Breast Center. This grouping is just an initial categorization; many other patient-specific factors are taken together to make a final decision.
No matter what, a PALPABLE-tumor situation is more likely to require lymph node sampling...at least a sentinel node sample (SLN).
Decisions may have to be made prior to having the whole tumor out and size-measurable. By whatever measure, the following are the criteria for assignment of size points (such are finally, ultimately, assigned from the pathology tissue studies):
| 0.1-0.9cm..................................................1 point |
| from 1.0 cm. to 1.4 cm.........................2 points |
| from 1.5-1.9 cm......................................3 points |
| from 2.0-3.0 cm......................................4 points |
| low grade...................................................1 point |
| not low grade........................................... 2 points |
| greater than 69 years old............1 point |
| 50-69 years old...............................2 points |
| less than 50 years old...................3 points |
| Groups: | <5% risk of ALN+ if KATS 3 or 4 sum | 20% risk of ALN+ if KATS 5, 6, or 7 sum | 50% risk of ALN+ if KATS 8 or 9 sum |
|---|---|---|---|
| Conclusions: | NO NODES NEEDED |
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(initially posted: 23 Dec. 2000)
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