A Nomogram Using Imaging Features to Predict Ipsilateral Breast Tumor Recurrence After Breast-Conserving Surgery for Ductal Carcinoma In Situ.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Bo Hwa Choi, Soohee Kang, Nariya Cho, Soo-Yeon Kim
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引用次数: 0

Abstract

Objective: To develop a nomogram that integrates clinical-pathologic and imaging variables to predict ipsilateral breast tumor recurrence (IBTR) in women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS).

Materials and methods: This retrospective study included consecutive women with DCIS who underwent BCS at two hospitals. Patients who underwent BCS between 2003 and 2016 in one hospital and between 2005 and 2013 in another were classified into development and validation cohorts, respectively. Twelve clinical-pathologic variables (age, family history, initial presentation, nuclear grade, necrosis, margin width, number of excisions, DCIS size, estrogen receptor, progesterone receptor, radiation therapy, and endocrine therapy) and six mammography and ultrasound variables (breast density, detection modality, mammography and ultrasound patterns, morphology and distribution of calcifications) were analyzed. A nomogram for predicting 10-year IBTR probabilities was constructed using the variables associated with IBTR identified from the Cox proportional hazard regression analysis in the development cohort. The performance of the developed nomogram was evaluated in the external validation cohort using a calibration plot and 10-year area under the receiver operating characteristic curve (AUROC) and compared with the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram.

Results: The development cohort included 702 women (median age [interquartile range], 50 [44-56] years), of whom 30 (4%) women experienced IBTR. The validation cohort included 182 women (48 [43-54] years), 18 (10%) of whom developed IBTR. A nomogram was constructed using three clinical-pathologic variables (age, margin, and use of adjuvant radiation therapy) and two mammographic variables (breast density and calcification morphology). The nomogram was appropriately calibrated and demonstrated a comparable 10-year AUROC to the MSKCC nomogram (0.73 vs. 0.66, P = 0.534) in the validation cohort.

Conclusion: Our nomogram provided individualized risk estimates for women with DCIS treated with BCS, demonstrating a discriminative ability comparable to that of the MSKCC nomogram.

利用成像特征预测原位乳管癌保乳术后同侧乳腺肿瘤复发的提名图
目的开发一种综合临床病理和影像学变量的提名图,用于预测接受保乳手术(BCS)的导管原位癌(DCIS)女性患者的同侧乳腺肿瘤复发(IBTR):这项回顾性研究包括在两家医院接受保乳手术(BCS)的连续性DCIS女性患者。2003年至2016年期间在一家医院接受BCS治疗的患者和2005年至2013年期间在另一家医院接受BCS治疗的患者分别被分为开发组和验证组。分析了12个临床病理变量(年龄、家族史、初始表现、核分级、坏死、边缘宽度、切除次数、DCIS大小、雌激素受体、孕激素受体、放疗和内分泌治疗)和6个乳腺X光检查和超声检查变量(乳腺密度、检测方式、乳腺X光检查和超声检查模式、钙化的形态和分布)。利用在研究队列中通过考克斯比例危险回归分析确定的与 IBTR 相关的变量,构建了预测 10 年 IBTR 概率的提名图。在外部验证队列中,使用校准图和10年接收器操作特征曲线下面积(AUROC)评估了所开发提名图的性能,并与纪念斯隆-凯特琳癌症中心(MSKCC)提名图进行了比较:开发队列包括 702 名女性(中位年龄[四分位数间距],50 [44-56] 岁),其中 30 名女性(4%)经历了 IBTR。验证队列包括 182 名妇女(48 [43-54] 岁),其中 18 人(10%)出现了 IBTR。利用三个临床病理变量(年龄、边缘、辅助放疗的使用情况)和两个乳腺 X 线摄影变量(乳腺密度和钙化形态)构建了一个提名图。该提名图经过适当校准,在验证队列中显示出与 MSKCC 提名图相当的 10 年 AUROC(0.73 vs. 0.66,P = 0.534):结论:我们的提名图为接受 BCS 治疗的 DCIS 妇女提供了个性化的风险估计,显示出与 MSKCC 提名图相当的鉴别能力。
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
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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