Benign-malignant breast nodule discrimination model based on age, tumor-associated autoantibody, ultrasonography and mammography.

Abstract

Background: Several studies have suggested an association between tumor-associated autoantibodies (TAAbs) and breast cancer. However, most research has focused on imaging techniques, with few studies examining the combined use of TAAbs and imaging to distinguish benign and malignant breast nodules.

Methods: Our study included 197 women with breast nodules. We collected clinical data, preoperative breast ultrasonography, and mammography results. Serum TAAbs were detected using enzyme-linked immunosorbent assay. Logistic regression analysis assessed the ability of factors to distinguish benign from malignant nodules. Receiver operating characteristic curves were plotted, and predictive models were constructed.

Results: Five TAAbs (BRCA2, TP53, ATAD2, NY-ESO-1, CAGE) exhibited significant differences (p < 0.001) between benign and malignant breast nodules, with specificity of 95.83% (area under the curve  = 0.722). Pearson's χ² results revealed a close association between the levels of 5-TAAbs and breast cancer stages. Additionally, preoperative 5-TAAbs combined with ultrasonography and mammography increased diagnostic accuracy of benign nodules by 10.42% and reduced misdiagnosis of malignant nodules by 14.85%. Multivariate logistic analysis identified age (p < 0.001), preoperative 5-TAAbs (p = 0.004), breast ultrasonography (p = 0.01), and mammography (p < 0.001) as independent factors for malignant nodules. Combining 5-TAAbs with age and imaging improved differentiation, achieving sensitivity of 85.42% and specificity of 94.06%.

Conclusion: Tumor-associated autoantibodies, especially the 5-TAAbs, have certain clinical value in the early diagnosis of breast cancer and can serve as an effective auxiliary tool for preoperative breast ultrasonography and mammography in patients with breast nodules.