|Table of Contents|

The value of nomogram model for predicting sentinel lymph node metastasis in breast cancer based on FFDM,ultrasound features and clinical factors

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 22
Page:
4304-4311
Research Field:
Publishing date:

Info

Title:
The value of nomogram model for predicting sentinel lymph node metastasis in breast cancer based on FFDM,ultrasound features and clinical factors
Author(s):
CAO Siwei1; LIU Xingyuan1; CHENG Xiaoying1; ZHANG Wuyue2; ZHENG Hongyan3; JIN Yantong1; ZHAO Mingming1; RUAN Ye1; GAO Bo1
1.Department of Radiology;2.Department of Ultrasound;3.Department of Pathology,the Second Affiliated Hospital of Harbin Medical University,Heilongjiang Harbin 150001,China.
Keywords:
breast cancer; FFDM; ultrasonography; sentinel lymph node metastasis; nomogram
PACS:
R737.9
DOI:
10.3969/j.issn.1672-4992.2024.22.014
Abstract:
Objective:To explore the value of preoperative full-field digital mammography (FFDM),ultrasound features and clinicopathological factors for predicting sentinel lymph node metastasis (SLNM) in breast cancer and to construct a nomogram model.Methods:416 breast cancer patients were retrospectively analyzed,and they were randomly divided into training set (n=291) and testing set (n=125) at a ratio of 7∶3.Lasso regression was used to identify predictive factors for SLNM,multivariate Logistic regression analysis was performed on the selected variables and a nomogram model was constructed based on the above factors.Results:ROC curve analysis results showed that when Youden=0.224,the optimal threshold of NLR was 2.37.The results of Lasso regression and Logistic regression analysis showed that FFDM features (spiculated margin of tumor,suspicious malignant calcification in the tumor,FFDM reported abnormal lymph nodes),ultrasonic features (blood flow in the tumor,US reported abnormal lymph nodes) were predictors of SLNM in breast cancer,and the AUC of nomogram model in training set and testing set were 0.841 and 0.811 respectively,it indicated good discrimination of the model,the optimal threshold of the model based on the ROC curve of the training set was 174.6 points.The calibration curve and clinical decision curve indicated that the nomogram model had good calibration and clinical benefits.Conclusion:The nomogram model based on FFDM,ultrasound characteristics and clinical factors can provide valuable reference for clinicians to predict SLNM in breast cancer noninvasively and accurately before surgery.

References:

［1］BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.Ca-Cancer J Clin,2024,74(3):229-263.
［2］BEEK MA,VERHEUVEL NC,LUITEN EJ,et al.Two decades of axillary management in breast cancer［J］.Brit J Surg,2015,102(13):1658-1664.
［3］王霞.彩色多普勒超声联合钼靶在乳腺癌普查中的应用［J］.中国医疗器械信息,2023,29(24):117-119. WANG X.Application of color doppler ultrasound combined with molybdenum target in breast cancer screening［J］.China Medical Device Information,2023,29(24):117-119.
［4］YUAN C,XU G,HAN X,et al.Molybdenum target mammography-based prediction model for metastasis of axillary sentinel lymph node in early-stage breast cancer［J］.Medicine,2023,102(42):e35672.
［5］YANG L,WANG HB,MA JP,et al.Association between the platelet to lymphocyte ratio,neutrophil to lymphocyte ratio and axillary lymph node metastasis in cT1N0 breast cancer patients［J］.American Journal of Translational Research,2021,13(3):1854-1861.
［6］梅章懿，蒋蓓琦，安敏，等.中性粒细胞淋巴细胞比及血小板淋巴细胞比预测乳腺癌非前哨淋巴结转移的价值分析［J］.现代肿瘤医学,2021,29(06):955-960. MEI ZY,JIANG BQ,AN M,et al.The value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting non-sentinel lymph node metastasis in breast cancer［J］.Modern Oncology,2021,29(06):955-960.
［7］中国抗癌协会乳腺癌专业委员会，中华医学会肿瘤学分会乳腺肿瘤学组.中国抗癌协会乳腺癌诊治指南与规范（2024年版）［J］.中国癌症杂志,2023,33(12):1092-1187. Breast Cancer Professional Committee of China Anti Cancer Association,Breast Cancer Group of Chinese Medical Association Oncology Branch.Guidelines and specifications for diagnosis and treatment of breast cancer of China anti cancer association (2024 edition)［J］.China Oncology,2023,33(12):1092-1187.
［8］COATES AS,WINER EP,GOLDHIRSCH A,et al.Tailoring therapies-improving the management of early breast cancer:St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015［J］.Ann Oncol,2015,26(8):1533-1546.
［9］GIAMMARILE F,VIDAL-SICART S,PAEZ D,et al.Sentinel lymph node methods in breast cancer［J］.Semin Nucl Med,2022,52(5):551-560.
［10］SUI X,FENG P,SUN X,et al.Correlation analysis of digital mammography,ultrasonography,and pathologic features in pure invasive micropapillary carcinoma of the breast (PIMPC)［J］.Breast Cancer (Dove Med Press)，2024,16:245-252.
［11］林文华，杨少玲，赫兰，等.基于术前超声及钼靶特征的列线图预测乳腺癌腋窝淋巴结转移的价值［J］.中国临床医学影像杂志,2023,34(09):647-653． LIN WH,YANG SL,HE L,et al.Value of nomogram based on preoperative ultrasound and mammography characteristics in predicting axillary lymph node metastasis of breast cancer［J］.Journal of China Clinic Medical Imaging,2023,34(09):647-653．
［12］丁玉梅，王志刚，赖华.钼靶X线特征与Her2、E-cadherin的关系及在乳腺癌腋窝淋巴结转移中的诊断效能［J］.广西医科大学学报,2023,40(08):1383-1389. DING YM,WANG ZG,LAI H.Relationship between mammographic features and Her2 as well as E-cadherin and their diagnostic efficacy in axillary lymph node metastasis of breast cancer［J］.Journal of Guangxi Medical University,2023,40(08):1383-1389.
［13］康亚圣，米成嵘，王文，等.乳腺癌超声毛刺征部位胶原纤维增生与预后因素的关系［J］.中国医学影像技术,2018,34(12):1820-1824. KANG YS,MI CR,WANG W,et al.Relationship between collagen fibrosis of ultrasound spiculations and prognostic factors inpatients with breast cancer［J］.Chinese Journal of Medical Imaging Technology,2018,34(12):1820-1824.
［14］NELSON JS,WELLS JR,BAKER JA,et al.How does c-view image quality compare with conventional 2D FFDM［J］.Med Phys，2016,43(5):2538-2547.
［15］NIU J,MA J,GUAN X,et al.Correlation between doppler ultrasound blood flow parameters and angiogenesis and proliferation activity in breast cancer［J］.Med Sci Monit,2019,25:7035-7041.
［16］GUO Q,DONG Z,ZHANG L,et al.Ultrasound features of breast cancer for predicting axillary lymph node metastasis［J］.J Ultras Med,2018,37(6):1345-1353.
［17］ITANI M,GRIFFIN A,WHITMAN G.Mammography of breast calcifications［J］.Imaging Med,2013,5(1):63-74.
［18］JIANG L,MA T,MORAN MS,et al.Mammographic features are associated with clinicopathological characteristics in invasive breast cancer［J］.Anticancer Res,2011,31(6):2327-2334.
［19］VAN LEEUWEN MM,DOYLE S,VAN DEN BELT-DUSEBOUT AW,et al.Clinicopathological and prognostic value of calcification morphology descriptors in ductal carcinoma in situ of the breast：a systematic review and meta-analysis［J］.Insights Imaging,2023,14(1):213-231.
［20］SONG D,YANG F,ZHANG Y,et al.Dynamic contrast-enhanced MRI radiomics nomogram for predicting axillary lymph node metastasis in breast cancer［J］.Cancer Imaging,2022,22(1):17-29.
［21］VALENTE SA,LEVINE GM,SILVERSTEIN MJ,et al.Accuracy of predicting axillary lymph node positivity by physical examination,mammography,ultrasonography,and magnetic resonance imaging［J］.Annals of Surgical Oncology，2012,19(6):1825-1830.
［22］MARINO MA,AVENDANO D,ZAPATA P,et al.Lymph node imaging in patients with primary breast cancer:concurrent diagnostic tools［J］.Oncologist,2020,25(2):e231-e242.
［23］YANG WT,CHANG J,METREWELI C.Patients with breast cancer:differences in color Doppler flow and gray-scale US features of benign and malignant axillary lymph nodes［J］.Radiology,2000,215(2):568-573.
［24］MOON G,NOH H,CHO IJ,et al.Prediction of late recurrence in patients with breast cancer:elevated neutrophil to lymphocyte ratio (NLR) at 5 years after diagnosis and late recurrence［J］.Breast Cancer,2019,27(1):54-61.
［25］KIM HY,KIM TH,YOON HK,et al.The role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting neoadjuvant chemotherapy response in breast cancer［J］.J Breast Cancer,2019,22(3):425-438.
［26］陈祥，蒋最明，顾敏，等.NLR、PLR与乳腺癌前哨淋巴结转移及临床病理特征之间的关系［J］.肿瘤药学,2020,10(06):719-723. CHEN X,JIANG ZM,GU M,et al.Relationship between NLR,PLR and sentinel lymph node metastasis and clinicopathologic features of breast cancer［J］.Anti-tumor Pharmacy,2020,10(06):719-723.
［27］GARCIA TE,PREZ RM,IVARS RA,et al.Deconstructing neutrophil to lymphocyte ratio (NLR) in early breast cancer:lack of prognostic utility and biological correlates across tumor subtypes［J］.Breast Cancer Res Tr,2024,205(3):475-485.
［28］王海龙，王运昌，张芳，等.超声引导下穿刺活检及NLR、PLR对乳腺癌腋窝淋巴结转移的诊断价值［J］.实用癌症杂志,2023,38(11):1891-1894. WANG HL,WANG YC,ZHANG F,et al.Value of ultrasound-guided needle biopsy,NLR and PLR in evaluating the axillary lymph node metastasis in breast cancer patients［J］.The Practical Journal of Cancer,2023,38(11):1891-1894.

Memo

Memo:
National Natural Science Foundation of China(No.62172129）；国家自然科学基金资助项目（编号：62172129）
Last Update: 1900-01-01