Prediction of non-sentinel lymph node metastases in T1-2 sentinel lymph node-positive breast cancer patients undergoing mastectomy following neoadjuvant therapy.
Humans
Female
Breast Neoplasms
/ pathology
Middle Aged
Lymphatic Metastasis
Mastectomy
Retrospective Studies
Neoadjuvant Therapy
/ methods
Sentinel Lymph Node Biopsy
/ methods
Sentinel Lymph Node
/ pathology
Nomograms
Adult
Axilla
Prognosis
Lymph Node Excision
/ methods
Follow-Up Studies
Aged
Lymph Nodes
/ pathology
ROC Curve
Neoplasm Staging
Carcinoma, Ductal, Breast
/ surgery
Breast cancer
Neoadjuvant therapy
Nomogram
non-SLN metastases
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
11
04
2024
accepted:
09
09
2024
medline:
29
9
2024
pubmed:
29
9
2024
entrez:
28
9
2024
Statut:
epublish
Résumé
Axillary lymph node dissection (ALND) is the standard axillary management for breast cancer patients with positive sentinel lymph node biopsy (SLNB) after neoadjuvant therapy. Nevertheless, when that happens, the frequency of additional positive nodes is not properly evaluated. We aim to develop a prediction model to assess the frequency of additional nodal disease after a positive sentinel lymph node following neoadjuvant therapy. We retrospectively analyzed the ultrasound and clinicopathological characteristics of breast cancer patients with 1-3 positive sentinel lymph nodes (SLN) undergoing mastectomy after neoadjuvant therapy (NAT) at our institution, and performed univariate and multivariate logistic analyses to confirm the factors affecting non-SLN metastasis. These factors were included to establish a nomogram, and the area under receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were utilized to assess the validity of this model. A total of 126 breast cancer patients were ultimately included in our study, 38 (53.5%) patients were diagnosed with non-SLN metastases of all 71 patients in training set. The results of multifactorial logistic analysis suggested that lymph node metastasis ratio (LNR), short axis of lymph node and progesterone receptor (PR) were strongly associated with non-SLN metastasis. We established a nomogram using the above three variables as predictors, which yielded an area under the curve of 0.795, and validated with a favorable AUC of 0.876. The nomogram we constructed can accurately predict the likelihood of non-SLN metastasis in our patients with 1-3 positive SLN after NAT, which may help guide decision making regarding axillary management.
Sections du résumé
BACKGROUND
BACKGROUND
Axillary lymph node dissection (ALND) is the standard axillary management for breast cancer patients with positive sentinel lymph node biopsy (SLNB) after neoadjuvant therapy. Nevertheless, when that happens, the frequency of additional positive nodes is not properly evaluated. We aim to develop a prediction model to assess the frequency of additional nodal disease after a positive sentinel lymph node following neoadjuvant therapy.
METHODS
METHODS
We retrospectively analyzed the ultrasound and clinicopathological characteristics of breast cancer patients with 1-3 positive sentinel lymph nodes (SLN) undergoing mastectomy after neoadjuvant therapy (NAT) at our institution, and performed univariate and multivariate logistic analyses to confirm the factors affecting non-SLN metastasis. These factors were included to establish a nomogram, and the area under receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were utilized to assess the validity of this model.
RESULTS
RESULTS
A total of 126 breast cancer patients were ultimately included in our study, 38 (53.5%) patients were diagnosed with non-SLN metastases of all 71 patients in training set. The results of multifactorial logistic analysis suggested that lymph node metastasis ratio (LNR), short axis of lymph node and progesterone receptor (PR) were strongly associated with non-SLN metastasis. We established a nomogram using the above three variables as predictors, which yielded an area under the curve of 0.795, and validated with a favorable AUC of 0.876.
CONCLUSION
CONCLUSIONS
The nomogram we constructed can accurately predict the likelihood of non-SLN metastasis in our patients with 1-3 positive SLN after NAT, which may help guide decision making regarding axillary management.
Identifiants
pubmed: 39342230
doi: 10.1186/s12957-024-03537-9
pii: 10.1186/s12957-024-03537-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
258Subventions
Organisme : Natural Science Foundation of Chongqing, China
ID : [No. CSTB2023NSCQ-MSX020]
Organisme : Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University
ID : Grant [2021] 24
Informations de copyright
© 2024. The Author(s).
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