A preoperative nomogram for predicting the risk of sentinel lymph node metastasis in patients with T1-2N0 breast cancer.

Abstract

To establish a preoperative nomogram based on the multimodal ultrasonographic features and biopsy results of primary lesion to predict the risk of sentinel lymph node metastasis (SLNM) in patients with T1-2N0 breast cancer. This study included 114 patients with T1-2N0 breast cancer who underwent ultrasound-guided core needle biopsy and multimodal ultrasound (Gray scale, Elastography, and Contrast-enhanced ultrasound) preoperatively. The pathological results of SLN were obtained from sentinel lymph node biopsy. Factors associated with sentinel lymph node metastasis were studied. The regression analysis identified the maximum diameter of tumor (p = 0.003), Doppler resistive index (p = 0.030), HER-2 status (p = 0.016) and the extended range of enhancement lesion (p = 0.010), which were used to establish a nomogram. The prediction model indicated that the value of area under the receiver-operating characteristic curve was 0.798. The calibration curve revealed that the nomogram possesses an excellent consistency between the predicted value and the actual value of SLNM (Hosmer-Lemeshow test: p = 0.436). The preoperative nomogram can effectively guide clinicians in predicting SLNM of breast cancer, and assist management of breast cancer patients through intuitive risk values to develop personalized treatment strategies.