Background: Several studies have concentrated on finding a combination of predictive parameters to establish a mathematical model that can identify patients with no axillary metastasis for whom routine lymph node dissection could be safely avoided. We developed a new model of nomogram (the Ulyanovsk Cancer Center axillary lymph node metastasis nomogram, UCC-ALNM nomogram); it employs clinically and pathologically relevant variables and offers possible advantages over the others nomograms. The purpose of the study: To assess the predictive power of UCC-ALNM nomogram. Methods: A total of 530 breast cancer patients treated between 2008 and 2010 were used as the modeling group for validating the UCC-ALNM nomogram. Clinical and pathologic features of patients were assessed by multivariable logistic regression to predict the presence of axillary metastasis in breast cancer patients. The predictive accuracy of our nomogram was measured by calculating the area under the receiver-operating characteristic (ROC) curve (AUC). Clinical factors included into analysis were: patient’s age and localization of the primary tumor. Pathological factors evaluated were: traditional pathological criteria (primary tumor size, histological type, tumor grade, HR- and Her-2 status) and new total pathological index (Ulyanovsk prognostic index - UPI), introduced by pathologists of the Ulyanovsk Regional Cancer Center. UPI is total score of six main pathological criteria that characterize the malignancy of epithelial tumors: degree of cellular differentiation, cellular polymorphism, mitotic activity, growth pattern, lymphovascular invasion, stromal reaction. Results: By the multivariate analysis, patient’s age (p=0.04), tumor size (p<0.001), UPI (p<0.001), PR (p<0.001) and Her2 status (p=0.02) were identified as independent predictors of axillary metastasis. The nomogram was then developed using the six variables associated with axillary metastasis: age, tumor size, PR, Her2, UPI. The new model was accurate and discriminating with an AUC of 0.7510 when applied to the modeling group. Conclusions: UPI is a new predictive factor of axillary metastasis in breast cancer patients. UCC-ALNM nomogram. Citation Format: Valery Rodionov, Vlada Cometova, Sergey Panchenko, Sereda Idrisova, Yurij Savinov, Maria Rodionova. A new nomogram to predict axillary metastasis in breast cancer patients without axillary surgery [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-01-30.
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