Purpose To explore the value of a nomogram based on ultrasound characteristics with clinicopathological indicators for predicting the risk of axillary lymph node metastasis in breast cancer.Materials and Methods A retrospective analysis was conducted on the ultrasonographic and clinicopathological data of 1 038 breast cancer patients(1 099 masses)with pathologically confirmed diagnoses,treated at the First Affiliated Hospital of Shihezi University from January 2014 to October 2021.Based on multivariate Logistic regression,the independent predictors associated with axillary lymph node metastasis were screened to establish a regression model and a nomogram.The data of validation group and calibration curve were used to verify the nomogram.The receiver operating characteristic curve and decision curve were drawn to evaluate the predictive efficacy of the nomogram.Results Multivariate Logistic analysis showed that the maximum diameter(OR=1.906,95%CI 1.397-2.609,P<0.001),aspect ratio(OR=0.425,95%CI 0.284-0.634,P<0.001),boundary(OR=0.373,95%CI 0.267-0.520,P<0.001),Adler blood flow grade(OR=3.188,95%CI 2.049-5.107,P<0.001),pathological type(OR=2.975,95%CI 1.759-5.267,P<0.001)and human epidermal growth factor receptor 2 expression status(OR=1.439,95%CI 1.048-1.982,P=0.025)were risk factors for predicting axillary lymph node metastasis.The nomogram prediction model was constructed based on the above 6 indicators,and the consistency index of the training group and the validation group was 0.712 and 0.749,respectively,the calibration curve(absolute mean error=0.019,0.014)and decision curve showed satisfactory forecasting ability.Conclusion The nomogram model for predicting axillary lymph node metastasis based on ultrasound characteristics and clinicopathological indicators of primary breast cancer can help to provide reference information for clinical diagnosis,treatment and prognosis evaluation.
Breast neoplasmsLymphatic metastasisUltrasonographyPathology,surgicalNomograms
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