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European Radiology
Published in: European Radiology 12/2022

28-09-2022 | Ultrasound | Breast

Predicting the risk of axillary lymph node metastasis in early breast cancer patients based on ultrasonographic-clinicopathologic features and the use of nomograms: a prospective single-center observational study

Authors: Wengcheng Fong, Luyuan Tan, Cui Tan, Hongli Wang, Fengtao Liu, Huan Tian, Shiyu Shen, Ran Gu, Yue Hu, Xiaofang Jiang, Jingsi Mei, Jing Liang, Tingting Hu, Kai Chen, Fengyan Yu

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

The purpose of this study was to establish two preoperative nomograms to evaluate the risk for axillary lymph node (ALN) metastasis in early breast cancer patients based on ultrasonographic-clinicopathologic features.

Methods

We prospectively evaluated 593 consecutive female participants who were diagnosed with cT1-3N0-1M0 breast cancer between March 2018 and May 2019 at Sun Yat-Sen Memorial Hospital. The participants were randomly classified into training and validation sets in a 4:1 ratio for the development and validation of the nomograms, respectively. Multivariate logistic regression analysis was performed to identify independent predictors of ALN status. We developed Nomogram A and Nomogram B to predict ALN metastasis (presence vs. absence) and the number of metastatic ALNs (≤ 2 vs. > 2), respectively.

Results

A total of 528 participants were evaluated in the final analyses. Multivariable analysis revealed that the number of suspicious lymph nodes, long axis, short-to-long axis ratio, cortical thickness, tumor location, and histological grade were independent predictors of ALN status. The AUCs of nomogram A in the training and validation groups were 0.83 and 0.78, respectively. The AUCs of nomogram B in the training and validation groups were 0.87 and 0.87, respectively. Both nomograms were well-calibrated.

Conclusion

We developed two preoperative nomograms that can be used to predict ALN metastasis (presence vs. absence) and the number of metastatic ALNs (≤ 2 vs. > 2) in early breast cancer patients. Both nomograms are useful tools that will help clinicians predict the risk of ALN metastasis and facilitate therapy decision-making about axillary surgery.

Key Points

• We developed two preoperative nomograms to predict axillary lymph node status based on ultrasonographic-clinicopathologic features.
• Nomogram A was used to predict axillary lymph node metastasis (presence vs. absence). The AUCs in the training and validation groups were 0.83 and 0.78, respectively. Nomogram B was used to estimate the number of metastatic lymph nodes ( ≤ 2 vs. > 2). The AUCs in the training and validation group were 0.87 and 0.87, respectively.
• Our nomograms may help clinicians weigh the risks and benefits of axillary surgery more appropriately.
Appendix
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Metadata
Title
Predicting the risk of axillary lymph node metastasis in early breast cancer patients based on ultrasonographic-clinicopathologic features and the use of nomograms: a prospective single-center observational study
Authors
Wengcheng Fong
Luyuan Tan
Cui Tan
Hongli Wang
Fengtao Liu
Huan Tian
Shiyu Shen
Ran Gu
Yue Hu
Xiaofang Jiang
Jingsi Mei
Jing Liang
Tingting Hu
Kai Chen
Fengyan Yu
Publication date
28-09-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08855-8

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