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Construction and validation of a novel nomogram for prediction of lymph node metastasis in HER2-positive breast cancer: based on the optimal number of examined lymph nodes for accurate nodal staging

  • 0Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, Fujian Province, 362000, China.
Bmc Women's Health +

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March 23, 2025

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March 23, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A new nomogram predicts lymph node metastasis in HER2-positive breast cancer using the optimal number of examined lymph nodes (ELNs) and other factors. This tool aids in accurate staging and personalized treatment for patients.

Area Of Science

  • Oncology
  • Medical Informatics

Background

  • Accurate prediction of lymph node metastasis is crucial for staging and treatment of HER2-positive breast cancer.
  • The optimal number of examined lymph nodes (ELNs) impacts the accuracy of nodal staging.

Purpose Of The Study

  • To construct and validate a novel nomogram for predicting lymph node metastasis in HER2-positive breast cancer.
  • To determine the optimal number of ELNs for accurate nodal staging.

Main Methods

  • Utilized SEER database data from 4,040 HER2-positive breast cancer patients, split into training (70%) and validation (30%) cohorts.
  • Identified the optimal number of ELNs using piecewise linear regression and evaluated associations with nodal metastasis via Logistic Regression and Random Forest.
  • Constructed a nomogram incorporating ELNs, radiotherapy, chemotherapy, T stage, and grade; performance assessed using ROC curves, calibration plots, and decision curve analysis.

Main Results

  • The optimal number of ELNs was determined to be 13.
  • Logistic Regression and Random Forest identified ELNs, radiotherapy, chemotherapy, T stage, and grade as independent predictors of nodal metastasis.
  • The nomogram achieved high predictive accuracy (AUC 0.829 in training, 0.833 in validation) and demonstrated good calibration (Brier scores 0.150 and 0.145).

Conclusions

  • A novel nomogram was developed for predicting lymph node metastasis in HER2-positive breast cancer.
  • The nomogram integrates the optimal number of ELNs with other key risk factors for individualized risk assessment.
  • This tool can enhance personalized treatment strategies for patients with HER2-positive breast cancer.

Keywords: