A novel nomogram and risk classification system for predicting lymph node metastasis of breast mucinous carcinoma: A SEER‐based study

Abstract

Background Mucinous breast cancer (MBC) is a rare disease, and patients with lymph node metastasis (LNM) have a poor prognosis. We aimed to explore the predictive factors of LNM and to construct a nomogram for predicting the risk of LNM and to identify the suitable axillary surgery for patients with diverse risks. Patients and Methods Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Chi‐square and rank‐sum tests were used to analyze the differences between groups. Survival analysis was performed with Kaplan–Meier curves and log‐rank tests. Independent factor identification and nomogram construction were performed with logistic regression analysis. The nomogram was qualified with a discrimination and calibration plot. Propensity score matching was performed to balance the disparities between groups. Results Patients with metastatic lymph nodes have a worse prognosis. Univariate and multivariate analyses indicated that tumor size, grade, and age were independent risk factors for LNM. The nomogram constructed with these three factors can predict the risk of LNM with high accuracy (AUC: 0.767, 95% CI: 0.697–0.838) and good calibration. Based on the nomogram, a risk classification system satisfactorily stratified the patients into 3 groups with diverse risks of LNM. In the low‐risk group, there were no significant differences between sentinel lymph node biopsy and no axillary surgery. In the middle‐ and high‐risk groups, both SLNB and axillary lymph node dissection were superior to no axillary surgery, with similar survival benefits. Conclusions The nomogram based on tumor size, grade, and age could conveniently and accurately predict the risk of LNM in MBC and assist clinicians in optimizing surgical strategies.

Nomogram for predicting outcomes in elderly women with mucinous breast cancer: A retrospective study combined with external validation in southwest China

“…However, some scholars have pointed out that tumor size may not be accurately measured, which may lead to bias in the judgment of prognosis 29 . However, the nomogram constructed by Wu et al shows that tumor size is an independent risk factor for predicting the probability of lymph node metastasis in MBC patients, and the larger the tumor, the higher the risk of lymph node metastasis 30 . For elderly MBC patients, our results also show that tumor size for patients with OS and CSS has a significant impact; the larger the tumor, the lower the OS and CSS, considering the bigger the tumor, the more difficult the operation and for elderly patients, due to a variety of comorbidities, the larger the tumor, the worse the tolerance of patients.…”

How to use the Surveillance, Epidemiology, and End Results (SEER) data: research design and methodology

“…They developed a nomogram that was internally and externally validated to predict the 1-, 3-, and 5-year OS rates for patients with inflammatory breast cancer. Wu et al [ 59 ] used a logistic regression model to identify 3 independent factors for the construction of a nomogram that can predict the lymph node metastatic status of breast mucinous carcinoma. The nomogram can also be constructed using a competing-risks model to predict the survival of patients with node-negative localized renal cell carcinoma [ 60 ].…”

Development of a prognostic model for long-term survival of young patients with bladder cancer: a retrospective analysis of the SEER Database

“…9 Nomograms have proven effective in predicting outcomes in various cancers, including breast cancer, endometrial cancer and thyroid cancer, aiding physicians in making informed clinical decisions and promoting personalised medicine through statistical presentation and result visualisation. [10][11][12] To address this gap, we investigated the clinicopathological characteristics of patients aged 40 years or younger and identified associated prognostic factors. Subsequently, we developed a nomogram to predict OS at 3, 5 and 10 years for YBCa, aiming to facilitate the establishment of individualised treatment plans and improve patient outcomes.…”

“… 9 Nomograms have proven effective in predicting outcomes in various cancers, including breast cancer, endometrial cancer and thyroid cancer, aiding physicians in making informed clinical decisions and promoting personalised medicine through statistical presentation and result visualisation. 10–12 …”