HER2-low-positive Borderline State Breast Cancer Prognosis Prediction Model Nomogram

ObjectiveAming to define and screen out HER2-low-positive borderline state breast cancers,analyze their clinical characteristics,and establish a clinical prediction model to predict the survival outcome of individuals with this type of breast cancer and provide a reference for treatment.MethodsWomen with borderline(borderline)HER2 status diagnosed by pathology from January 1,2010 to December 31,2015 in the US Epidemiologic Surveillance,Epidemiology,and End Results(SEER)database were extracted by SEER*Stat software.Patients with invasive breast cancer were randomly sampled and grouped,and 70% of the samples were set as the modeling group and 30% as the self-validation group.Patients with Cer Bb-2=2+,Fish result of HER2/CEP17<2,and HER2 copy number/cell ∈ [4,6)from January 1,2019 to March 1,2022 at the Second Hospital of Shanxi Medical University were selected as the out-validation group.Factors included in the exploration included: age,race,marriage,right and left tumor location,histological grade,estrogen and progesterone receptor status,TNM stage and whether surgery and radiotherapy were performed.Multifactorial analysis was performed on the modeling group to clarify the overall survival index,plot a columnar line graph of the overall survival of female patients with this subtype of breast cancer,and further predict their 3-year and 5-year survival rates.The models were validated with internal and external validation groups for identification and calibration,respectively.ResultsA total of 11,204 HER2-low-positive borderline state breast cancer patients data were included,of which 11,148 cases were screened in the SEER database,the number of modeling group after randomization was 7,803 patients,and the number of inter-validation group was 3,345 patients.Fifty-six patients from the Second Hospital of Shanxi Medical University were screened.the results of multifactor analysis of Cox proportional risk model indicated that age,race,marriage,histological grade,estrogen and progesterone receptor status,TNM stage and means of surgery and radiotherapy were risk factors affecting prognostic survival of breast cancer(P<0.05).the above risk factors were used to construct a predictive column line graph predicting 3-year 5-year survival,and 3-year survival of The area under the subject characteristics(ROC)curve was 0.699,and the corrected curves in both the modeling and internal and external validation groups were close to the 45°curve,demonstrating that this column line plot can better predict individual survival in breast cancer patients with a borderline state of low HER2 expression.ConclusionThis prognostic prediction model provides a reliable and effective method for predicting the prognosis of HER2-low-positive borderline state breast cancer.