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Development and Validation of an Ultrasound and Clinicopathological Features-Based Nomogram for Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Patients: A Single-Center Observational Study

  • 0Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Journal of Clinical Ultrasound : Jcu +

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March 17, 2025

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March 17, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

This study developed a nomogram using ultrasound and clinical data to predict non-sentinel lymph node metastasis (NSLNM) in early breast cancer patients with positive sentinel lymph nodes (SLNs). The tool aids clinicians in assessing NSLNM risk and guiding axillary lymph node treatment decisions.

Area Of Science

  • Oncology
  • Radiology
  • Surgical Pathology

Background

  • Accurate assessment of non-sentinel lymph node metastasis (NSLNM) is crucial for early breast cancer management.
  • Sentinel lymph node (SLN) status alone may not fully determine the need for further axillary lymph node (ALN) dissection.
  • Predictive tools are needed to stratify risk and personalize treatment for patients with positive SLNs.

Purpose Of The Study

  • To develop and validate a nomogram for predicting the risk of NSLNM in early breast cancer patients with positive SLNs.
  • To integrate ultrasound and clinicopathological variables into a predictive model.
  • To provide a clinical decision-making tool for ALN management.

Main Methods

  • Retrospective analysis of 438 early breast cancer patients with positive SLNs.
  • Development and validation of a nomogram using training (70%) and testing (30%) datasets.
  • Multivariable logistic regression to identify independent predictors of NSLNM.

Main Results

  • Key predictors for NSLNM included SLN percentage, lesion characteristics, longest tumor diameter, and ultrasound-detected suspicious ALNs.
  • The developed nomogram demonstrated good predictive accuracy, with an Area Under the Curve (AUC) of 0.84 (training set) and 0.82 (testing set).
  • The nomogram showed strong calibration, indicating reliable risk assessment.

Conclusions

  • A novel nomogram integrating ultrasound and clinicopathological features effectively predicts NSLNM risk in early breast cancer.
  • This tool assists clinicians in making informed decisions regarding axillary lymph node treatment.
  • The nomogram serves as a valuable reference for personalized management strategies in breast cancer care.

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