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Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer

  • Authors:
    • Jiejie Yao
    • Wei Zhou
    • Ying Zhu
    • Jianqiao Zhou
    • Xiaosong Chen
    • Weiwei Zhan
  • View Affiliations / Copyright

    Affiliations: Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, P.R. China, Comprehensive Breast Health Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, P.R. China
    Copyright: © Yao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 95
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    Published online on: January 11, 2024
       https://doi.org/10.3892/ol.2024.14228
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Abstract

Axillary lymph node (ALN) status is a key prognostic factor in patients with early‑stage invasive breast cancer (IBC). The present study aimed to develop and validate a nomogram based on multimodal ultrasonographic (MMUS) features for early prediction of axillary lymph node metastasis (ALNM). A total of 342 patients with early‑stage IBC (240 in the training cohort and 102 in the validation cohort) who underwent preoperative conventional ultrasound (US), strain elastography, shear wave elastography and contrast‑enhanced US examination were included between August 2021 and March 2022. Pathological ALN status was used as the reference standard. The clinicopathological factors and MMUS features were analyzed with uni‑ and multivariate logistic regression to construct a clinicopathological and conventional US model and a MMUS‑based nomogram. The MMUS nomogram was validated with respect to discrimination, calibration, reclassification and clinical usefulness. US features of tumor size, echogenicity, stiff rim sign, perfusion defect, radial vessel and US Breast Imaging Reporting and Data System category 5 were independent risk predictors for ALNM. MMUS nomogram based on these factors demonstrated an improved calibration and favorable performance [area under the receiver operator characteristic curve (AUC), 0.927 and 0.922 in the training and validation cohorts, respectively] compared with the clinicopathological model (AUC, 0.681 and 0.670, respectively), US‑depicted ALN status (AUC, 0.710 and 0.716, respectively) and the conventional US model (AUC, 0.867 and 0.894, respectively). MMUS nomogram improved the reclassification ability of the conventional US model for ALNM prediction (net reclassification improvement, 0.296 and 0.288 in the training and validation cohorts, respectively; both P<0.001). Taken together, the findings of the present study suggested that the MMUS nomogram may be a promising, non‑invasive and reliable approach for predicting ALNM.
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Copy and paste a formatted citation
Spandidos Publications style
Yao J, Zhou W, Zhu Y, Zhou J, Chen X and Zhan W: Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer. Oncol Lett 27: 95, 2024.
APA
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., & Zhan, W. (2024). Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer. Oncology Letters, 27, 95. https://doi.org/10.3892/ol.2024.14228
MLA
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., Zhan, W."Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer". Oncology Letters 27.3 (2024): 95.
Chicago
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., Zhan, W."Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer". Oncology Letters 27, no. 3 (2024): 95. https://doi.org/10.3892/ol.2024.14228
Copy and paste a formatted citation
x
Spandidos Publications style
Yao J, Zhou W, Zhu Y, Zhou J, Chen X and Zhan W: Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer. Oncol Lett 27: 95, 2024.
APA
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., & Zhan, W. (2024). Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer. Oncology Letters, 27, 95. https://doi.org/10.3892/ol.2024.14228
MLA
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., Zhan, W."Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer". Oncology Letters 27.3 (2024): 95.
Chicago
Yao, J., Zhou, W., Zhu, Y., Zhou, J., Chen, X., Zhan, W."Predictive nomogram using multimodal ultrasonographic features for axillary lymph node metastasis in early‑stage invasive breast cancer". Oncology Letters 27, no. 3 (2024): 95. https://doi.org/10.3892/ol.2024.14228
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