Nomogram Based on Clinicopathologic and US Characteristics: Axillary Nodal Evaluation Following Neoadjuvant Chemotherapy in Patients with Biopsy-Proven Node-Positive Breast Cancer
Abstract Objective: To avoid surgical over-treatment of the axilla in patients with lymph node (LN) conversion following neoadjuvant chemotherapy (NAC), high-performing axilla staging procedures are needed. This study is designed to develop a convenient modality to predict the axillary response to NAC in breast cancer patients.Methods: In this retrospective study, a total of 1046 patients with breast cancer who received NAC followed by axillary lymph node dissection (ALND) between 2015 and 2021 were identified from a maintained database. The training set included 607 breast cancer patients with biopsy proven positive LNs at initial diagnosis, and receiving NAC followed by ALND. Clinicopathologic and ultrasound (US) characteristics were analyzed, and a nomogram was generated to predict the probability of axillary LNs residual metastasis. The predictive performances of models were assessed using multivariate logistic regression and receiver operator characteristic curve (ROC) analyses. The nomogram integrating clinicopathological and US characteristics was validated with an external cohort of 242 patients.Results: In this study, 49.75% and 32.23% patients achieved axillary pathological complete response (pCR) after NAC in the training and external validation sets, respectively. Multivariate analysis indicated that expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), Ki-67 score, and clinical nodal stage were independently significant factors for predicting the nodal response to NAC. Location and radiological response of primary tumors, cortical thickness and shape of LNs on US were also significantly associated with nodal pCR. The area under the ROC curve (AUC), estimating the ability of clinicopathologic model to determine axillary status after NAC, was 0.72 and that of US model was 0.81 in the training cohort. AUCs of the nomogram based on clinicopathologic and US characteristics for the training and validation sets were 0.86 and 0.82, respectively.Conclusions: Nomogram incorporating routine clinicopathologic and US characteristics can predict nodal pCR in node-positive breast cancer patients receiving NAC and may be a feasible modality to aid clinicians in treatment decisions..
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Preprint| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
ResearchSquare.com - (2022) vom: 15. Juni Zur Gesamtaufnahme - year:2022 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Huang, Jia-Xin [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-1699310/v1 |
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| PPN (Katalog-ID): |
XRA036164054 |
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| 520 | |a Abstract Objective: To avoid surgical over-treatment of the axilla in patients with lymph node (LN) conversion following neoadjuvant chemotherapy (NAC), high-performing axilla staging procedures are needed. This study is designed to develop a convenient modality to predict the axillary response to NAC in breast cancer patients.Methods: In this retrospective study, a total of 1046 patients with breast cancer who received NAC followed by axillary lymph node dissection (ALND) between 2015 and 2021 were identified from a maintained database. The training set included 607 breast cancer patients with biopsy proven positive LNs at initial diagnosis, and receiving NAC followed by ALND. Clinicopathologic and ultrasound (US) characteristics were analyzed, and a nomogram was generated to predict the probability of axillary LNs residual metastasis. The predictive performances of models were assessed using multivariate logistic regression and receiver operator characteristic curve (ROC) analyses. The nomogram integrating clinicopathological and US characteristics was validated with an external cohort of 242 patients.Results: In this study, 49.75% and 32.23% patients achieved axillary pathological complete response (pCR) after NAC in the training and external validation sets, respectively. Multivariate analysis indicated that expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), Ki-67 score, and clinical nodal stage were independently significant factors for predicting the nodal response to NAC. Location and radiological response of primary tumors, cortical thickness and shape of LNs on US were also significantly associated with nodal pCR. The area under the ROC curve (AUC), estimating the ability of clinicopathologic model to determine axillary status after NAC, was 0.72 and that of US model was 0.81 in the training cohort. AUCs of the nomogram based on clinicopathologic and US characteristics for the training and validation sets were 0.86 and 0.82, respectively.Conclusions: Nomogram incorporating routine clinicopathologic and US characteristics can predict nodal pCR in node-positive breast cancer patients receiving NAC and may be a feasible modality to aid clinicians in treatment decisions. | ||
| 700 | 1 | |a Huang, Jia-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yi-Jie |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xue-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Yan-Fen |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Ming-Jie |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Li-Na |e verfasserin |4 aut | |
| 700 | 1 | |a Pei, Xiao-Qing |e verfasserin |4 aut | |
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