Construction of nomogram model for predicting axillary lymph node status after neoadjuvant chemotherapy in breast cancer
XU Zichen
WANG Bochang
WANG Hao
GAO Yue
ZHI Xiangcheng
Abstract：Objective To analyze the factors influencing axillary lymph node metastasis(ALNM)in breast cancer patients after neoadjuvant chemotherapy(NAC),and to construct a nomogram prediction model of ALNM after NAC.Methods The clinical records of 154 patients with breast cancer who received NAC treatment in our hospital from March 2018 to September 2021 were retrospectively collected.According to the status of axillary lymph nodes after NAC,patients were divided into ALNM group(110 cases)and axillary lymph node non metastasis group(ALNNM,44 cases).Single factor and multi factor logistic regression analysis were used to determine the factors affecting ALNM,and R software was used to construct a column chart prediction model.Evaluate the diagnostic efficacy of nomograms by drawing receiver operating characteristic(ROC)curves and calibration curves.Results The logistic regression model analysis showed that cN1-3 staging,estrogen receptor(ER)positivity,Ki-67 high expression,tumor regression degree＞1,and breast ultrasound imaging report and data system(BI-RADS)≥4 were independent risk factors for the occurrence of ALNM in patients with NAC(P＜0.05).Based on these 5 variables,a column chart model was constructed,and the predicted area under the ROC curve was 0.888(95%CI:0.807-0.968).The C index of the model was 0.788(95%CI:0.710-0.865).Through bootstrap sampling calibration,the model has good consistency between the predicted generalization probability and the actual generalization probability.The decision curve analysis shows that the column graph model has a higher net return within the broad risk threshold range of 15%to 50%.Conclusion cN staging,ER,Ki-67,primary tumor regression and BI-RADS grading after NAC can be used to predict ALNM in breast cancer patients after NAC,which may be helpful to clinical.
Keywords：Breast cancerAxillary lymph node metastasisNeoadjuvant chemotherapyNomograph
Publication Date：2023-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 893-897 )