Multimodal Ultrasound and Clinical Pathological Model for Predicting Axillary Lymph Node Metastasis in Breast Cancer

MIAO Guie; HE Xiuli; GUO Lingling; YANG Shuang

doi:10.3969/j.issn.2096-305X.2025.02.008

Abstract：Objective To explore the value of establishing a nomogram model based on conventional ultrasonic features,quantitative parameters of shear wave elastography(SWE),superb microvascular imaging(SMI)technology,and clinical pathological features in predicting axillary lymph node metastasis(ALNM)in breast cancer patients.Methods The ultrasound and clinicopathological data of 256 breast cancer patients who were diagnosed and underwent radical mastectomy in the First Affiliated Hospital of Jinzhou Medical University were retrospectively analyzed.Patients were randomly divided into a training group(n=192)and a validation group(n=64)in a 3∶1 ratio.Differences in ultrasound and clinicopathological data between the two groups were analyzed.Both univariate and multivariate Logistic regression analyses were performed to identify independent risk factors for ALNM.Additionally,a nomogram model was developed to assess the model's discrimination ability,calibration accuracy,and clinical relevance.Results The diameter,margin,ultrasound diagnosis of axillary lymph node(ALN)status,maximum Young's modulus(Emax)and Ki-67 of primary lesion were independent predictors of ALNM.Based on these,a nomogram model for predicting ALNM was constructed.The AUC,sensitivity and specificity of training group were 0.838(95％CI:0.778-0.898),87.5％and 66.7％,respectively.The AUC,sensitivity and specificity of validation group were 0.825(95％CI:0.717-0.932),84.6％and 72.0％,respectively.Conclusion The nomogram model based on multimodal ultrasound and clinicopathological features can provide certain value for clinical evaluation of breast cancer patients with ALNM.