Use of Natural Language Understanding to Facilitate Surgical De-Escalation of Axillary Staging in Patients With Breast Cancer.

IF 3.3 Q2 ONCOLOGY

JCO Clinical Cancer Informatics Pub Date : 2024-05-01 DOI:10.1200/CCI.23.00177

Neil Carleton, Gilan Saadawi, Priscilla F McAuliffe, Atilla Soran, Steffi Oesterreich, Adrian V Lee, Emilia J Diego

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引用次数: 0

Abstract

Purpose: Natural language understanding (NLU) may be particularly well equipped for enhanced data capture from the electronic health record given its examination of both content-driven and context-driven extraction.

Methods: We developed and applied a NLU model to examine rates of pathological node positivity (pN+) and rates of lymphedema to determine whether omission of routine axillary staging could be extended to younger patients with estrogen receptor-positive (ER+)/cN0 disease.

Results: We found that rates of pN+ and arm lymphedema were similar between patients age 55-69 years and ≥70 years, with rates of lymphedema exceeding rates of pN+ for clinical stage T1c and smaller disease.

Conclusion: Data from our NLU model suggest that omission of sentinel lymph node biopsy might be extended beyond Choosing Wisely recommendations, limited to those older than 70 years and to all postmenopausal women with early-stage ER+/cN0 disease. These data support the recently reported SOUND trial results and provide additional granularity to facilitate surgical de-escalation.

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利用自然语言理解促进乳腺癌患者腋窝分期的手术切除。

目的：鉴于自然语言理解（NLU）对内容驱动和上下文驱动提取的检查，它可能特别适合从电子健康记录中增强数据采集：我们开发并应用了一个 NLU 模型来检查病理结节阳性率（pN+）和淋巴水肿率，以确定是否可以将常规腋窝分期的遗漏扩展到雌激素受体阳性（ER+）/cN0 疾病的年轻患者：我们发现，55-69岁和≥70岁患者的pN+率和手臂淋巴水肿率相似，临床分期为T1c和更小的患者的淋巴水肿率超过了pN+率：来自我们的 NLU 模型的数据表明，前哨淋巴结活检的省略可能会超出 Choosing Wisely 建议的范围，仅限于 70 岁以上的患者和所有患有早期 ER+/cN0 疾病的绝经后妇女。这些数据支持了最近报道的 SOUND 试验结果，并为促进手术降级提供了更多细节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JCO Clinical Cancer Informatics ONCOLOGY-

CiteScore

6.20

自引率

4.80%

发文量

190