A Nomogram Prediction Model For Axillary Lymph Node Metastasis Of Breast Cancer Patients

Objective:A study about the correlation between the age,general characteristics,ultrasound,molybdenum target,pathological results and axillary lymph node metastasis in breast cancer patients.And we aimed to develop a nomogram prediction model to predict the probability of axillary lymph node metastasis.Methods:We retrospectively collected 388 female breast cancer patients who are hospitalized in the first affiliated hospital of nanchang university from January 1,2015 to January 1,2019.They were randomly divided into a training cohort(291 cases)and a validation cohort(97 cases)at a rate of 3:1.In the training cohort,univariate logistic analysis was carried out on patients’ age,general tumor characteristics(vector,tumor location,tumor quadrant,tumor maximum diameter),ultrasound,mammography,and pathological results were analyzed by univariate logistic analysis.Those with statistical significance were included in multivariate logistic analysis,the nomogram prediction model was established and the nomogram prediction model was plotted.The subject operating characteristic(ROC)curve,calibration curve and hosmer-lemeshow test were used for model evaluation.Results:Age,general characteristics,ultrasound,mammography and pathological results showed no statistical differences between the modeling group and the validation group.Multivariate logistic analysis found that the tumor maximum diameter,axillary lymph node(ultrasound),axillary lymph node(mammography),estrogen receptor(ER)and pathological types were independent risk factors for axillary lymph node metastasis,and the nomogram prediction model was constructed by using these five variables..The area under the curve(AUC)of the training cohort and validation cohort were respectively 0.755 and 0.716,and the hosmer-lemeshow test goodness of fit was respectively P=0.888 and P=0.509.The sensitivity and false-negative rates of the nomogram were 100% and 0 for the predicted risk cut-off values of 20% respectively.Conclusion:In breast cancer patients,tumor maximum diameter,axillary lymph node(ultrasound),axillary lymph node(mammography),ER,and pathological types were independent risk factors for axillary lymph node metastasis.The nomogram model established in this study can provide a relatively accurate and objective tool for predicting the risk of axillary lymph node metastasis of breast cancer.When the predicted risk is less than 20%,lymph node-related surgery may be avoided.