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Fig. 5 —Graph shows staging strategy preference as function of
long-term quality-of-life sequelae from sentinel lymph node (SLN) biopsy and
axillary lymph node dissection. Strategy preference was sensitive to utility
adjustments that accounted for potential long-term adverse effects of SLN
biopsy and axillary lymph node dissection. For most utility values considered,
MR lymphangiography alone was preferred (MR lymphangiography had greater
associated quality-adjusted life expectancy than other strategies and was not
strongly or weakly dominated). If both procedural utility values were very
high, combined MR lymphangiography and SLN biopsy was preferred. However, if
post–SLN biopsy utilities were very high and if post–axillary
lymph node dissection utilities were relatively slightly lower, SLN biopsy
alone was preferred. Because of lack of published data to inform values, no
utility adjustments were made in base-case analysis.
